Provider Demographics
NPI:1124131453
Name:MORLEY, MARSHALL WALTER (DDS)
Entity type:Individual
Prefix:
First Name:MARSHALL
Middle Name:WALTER
Last Name:MORLEY
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 1:7 WOODS DR
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-1455
Mailing Address - Country:US
Mailing Address - Phone:231-526-7556
Mailing Address - Fax:
Practice Address - Street 1:2692 S STRAITS HWY
Practice Address - Street 2:
Practice Address - City:INDIAN RIVER
Practice Address - State:MI
Practice Address - Zip Code:49749-9792
Practice Address - Country:US
Practice Address - Phone:231-238-9346
Practice Address - Fax:231-238-0369
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010113321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice