Provider Demographics
NPI:1346817442
Name:MCDERMOTT, MORGAN MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:MARIE
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6631 HILLSIDE RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:OH
Mailing Address - Zip Code:44131-5348
Mailing Address - Country:US
Mailing Address - Phone:216-870-0461
Mailing Address - Fax:
Practice Address - Street 1:3637 MEDINA RD STE 100
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8153
Practice Address - Country:US
Practice Address - Phone:330-725-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-07
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0264861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice