Organization
MODERN DENTAL OF SPRINGFIELD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ALLEN MORLEY DMD (PARTNER)
(217) 698-3400
Entity
Organization
Contact information
Practice address
3240 HEDLEY RD STE B, SPRINGFIELD, IL 62711-6360
(217) 698-3400
(217) 698-3410
Mailing address
3240 HEDLEY RD STE B, SPRINGFIELD, IL 62711-6360
(217) 698-3400
(217) 698-3410
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1083793939
DENTIST
IL
01
—
1528441557
DENTIST
IL
Enumeration date
03/22/2021
Last updated
03/22/2021
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