Provider Demographics
NPI:1346356714
Name:MORRIS, DAVID ALAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALAN
Last Name:MORRIS
Suffix:
Gender:M
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:PO BOX 1209
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072
Mailing Address - Country:US
Mailing Address - Phone:804-642-2112
Mailing Address - Fax:804-642-1108
Practice Address - Street 1:2674 B GEORGE WASHINGTON MEM HIGHWAY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072
Practice Address - Country:US
Practice Address - Phone:804-642-2112
Practice Address - Fax:804-642-1108
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010070341223X0400X
MSOR-561-191223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
730062OtherUNITED CONCORDIA INS
070651OtherANTHEM INS CO
VA010186790Medicaid