Provider Demographics
NPI:1447938733
Name:SCHOLTES, MORGAN (DDS)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:SCHOLTES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21705 S COUNTY LINE RD
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60404-7657
Mailing Address - Country:US
Mailing Address - Phone:815-545-5321
Mailing Address - Fax:
Practice Address - Street 1:4201 1ST AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5338
Practice Address - Country:US
Practice Address - Phone:319-364-7108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS621181223G0001X
IA10191122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice