Provider Demographics
NPI:1679732366
Name:VIRTS, MICHAEL T (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:T
Last Name:VIRTS
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 1:77 THOMAS JOHNSON DR STE A
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4893
Mailing Address - Country:US
Mailing Address - Phone:301-682-3887
Mailing Address - Fax:
Practice Address - Street 1:1150 OMEGA DR STE 102
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5784
Practice Address - Country:US
Practice Address - Phone:240-513-6161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2024-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD142341223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry