Healthcare Provider Details

I. General information

NPI: 1760893176
Provider Name (Legal Business Name): MICHAEL MORRIS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2014
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 PEARL ST
BURLINGTON VT
05401-8573
US

IV. Provider business mailing address

258 PEARL ST
BURLINGTON VT
05401-8573
US

V. Phone/Fax

Practice location:
  • Phone: 802-863-4146
  • Fax:
Mailing address:
  • Phone: 802-863-4146
  • Fax: 802-862-7571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberVT107639
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: