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General NPI Number Information
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NPI Number | 1720617160
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Entity Type | Individual
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Provider Name | MORGAN KESECKER BISHOP
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Gender | Female
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 09/15/2023
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Provider Practice Location Address
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Address Line | 1880 COUNTRY CLUB RD
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City | HARRISONBURG
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State | VA
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Zip | 22802-8858
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Country | US
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Telephone | 540-433-3636
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Fax |
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Provider Business Mailing Address
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Address Line | 247 PALISADES DR
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City | MORGANTOWN
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State | WV
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Zip | 26508-9009
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Country | US
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Telephone | 304-619-6054
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 4475
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License Number State | WV
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