Provider Demographics
NPI:1568948552
Name:STEELY, MORGAN (DDS)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:STEELY
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 E DAY RD STE 150
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-3463
Mailing Address - Country:US
Mailing Address - Phone:574-800-5080
Mailing Address - Fax:
Practice Address - Street 1:230 E DAY RD STE 150
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3463
Practice Address - Country:US
Practice Address - Phone:574-800-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-13
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022760122300000X
OH30.0257191223G0001X
IN12014022A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist