Provider Demographics
NPI:1194928887
Name:MORGAN, KELLY ELIZABETH (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ELIZABETH
Last Name:MORGAN
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Gender:F
Credentials:DMD, MS
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Mailing Address - Street 1:19420 GOLF VISTA PLAZA
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LANSDOWNE
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-723-5900
Mailing Address - Fax:703-723-5592
Practice Address - Street 1:19420 GOLF VISTA PLAZA
Practice Address - Street 2:SUITE 120
Practice Address - City:LANSDOWNE
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-723-5900
Practice Address - Fax:703-723-5592
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2012-11-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA040114114811223X0400X
VA04014114811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics