Healthcare Provider Details

I. General information

NPI: 1609858570
Provider Name (Legal Business Name): MICHAEL FIELDS MORRIS D.D.S, ABE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3107 HUNGARY SPRING RD
RICHMOND VA
23228-2421
US

IV. Provider business mailing address

3107 HUNGARY SPRING RD
RICHMOND VA
23228-2421
US

V. Phone/Fax

Practice location:
  • Phone: 804-501-0501
  • Fax: 804-501-0509
Mailing address:
  • Phone: 804-501-0501
  • Fax: 804-501-0509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number0401007677
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: