Provider Demographics
NPI:1104092592
Name:MORCH, MICHAEL HAROLD (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HAROLD
Last Name:MORCH
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 1:3138 GOLANSKY BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-4260
Mailing Address - Country:US
Mailing Address - Phone:703-878-7969
Mailing Address - Fax:703-730-9907
Practice Address - Street 1:3138 GOLANSKY BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4260
Practice Address - Country:US
Practice Address - Phone:703-878-7969
Practice Address - Fax:703-730-9907
Is Sole Proprietor?:No
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1000406349122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist