Provider Demographics
NPI:1598811077
Name:MORGAN, GARY H (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:H
Last Name:MORGAN
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 1:2301 HILLIARD RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-4525
Mailing Address - Country:US
Mailing Address - Phone:804-266-8769
Mailing Address - Fax:
Practice Address - Street 1:2301 HILLIARD RD
Practice Address - Street 2:SUITE 11
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228-4525
Practice Address - Country:US
Practice Address - Phone:804-266-8769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA85941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice