Provider Demographics
NPI:1346909702
Name:VERHAGE, MORGAN
Entity Type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:
Last Name:VERHAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 DORCHESTER RD STE 104
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29420-7382
Mailing Address - Country:US
Mailing Address - Phone:843-473-6636
Mailing Address - Fax:
Practice Address - Street 1:1765 HICKORY KNL
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-8302
Practice Address - Country:US
Practice Address - Phone:803-487-1231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-14
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9622122300000X
SC104721223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist