Provider Demographics
NPI:1780173179
Name:WOYTOWITZ, MORGAN KELLY (DDS)
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:KELLY
Last Name:WOYTOWITZ
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 1:3024 PATUXENT OVERLOOK CT
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-2250
Mailing Address - Country:US
Mailing Address - Phone:410-461-4160
Mailing Address - Fax:
Practice Address - Street 1:3444 ELLICOTT CENTER DR STE 202
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-4110
Practice Address - Country:US
Practice Address - Phone:410-461-4288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-01
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN236591223G0001X
390200000X
MD168111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program