Provider Demographics
NPI:1134237613
Name:MORRIS, MADELYN GAY (DDS)
Entity type:Individual
Prefix:MRS
First Name:MADELYN
Middle Name:GAY
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:MADELYN
Other - Middle Name:GAY
Other - Last Name:GAMBREL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3107 HUNGARY SPRING RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23228
Mailing Address - Country:US
Mailing Address - Phone:804-501-0501
Mailing Address - Fax:804-501-0509
Practice Address - Street 1:3107 HUNGARY SPRING RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23228
Practice Address - Country:US
Practice Address - Phone:804-501-0501
Practice Address - Fax:804-501-0509
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411163122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist