Provider Demographics
NPI:1083793939
Name:MORLEY, MICHAEL A (DMD)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:A
Last Name:MORLEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 QUAIL XING
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:62563-9520
Mailing Address - Country:US
Mailing Address - Phone:217-498-7006
Mailing Address - Fax:
Practice Address - Street 1:3240 HEDLEY RD
Practice Address - Street 2:SUITE B
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62711-6360
Practice Address - Country:US
Practice Address - Phone:217-698-3400
Practice Address - Fax:217-698-3410
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0247381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice