Provider Demographics
NPI:1174757520
Name:CHAMBERS, MORGAN WELLS (DMD)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:WELLS
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:WELLS
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:3475 RICHMOND RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2500
Mailing Address - Country:US
Mailing Address - Phone:859-396-7179
Mailing Address - Fax:859-543-0881
Practice Address - Street 1:3475 RICHMOND RD
Practice Address - Street 2:SUITE 100
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2500
Practice Address - Country:US
Practice Address - Phone:859-543-0505
Practice Address - Fax:859-543-0881
Is Sole Proprietor?:No
Enumeration Date:2009-05-13
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY87501223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist