Provider Demographics
NPI:1033412325
Name:MORRIS, TRACY SCHNEIDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:TRACY
Middle Name:SCHNEIDER
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 TUCKER AVE
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-1630
Mailing Address - Country:US
Mailing Address - Phone:731-635-0166
Mailing Address - Fax:731-635-0167
Practice Address - Street 1:201 TUCKER AVE
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-1630
Practice Address - Country:US
Practice Address - Phone:731-635-0166
Practice Address - Fax:731-635-0167
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS46971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN061001OtherBLUE CROSS, BLUE SHIELD
535959OtherUNITED CONCORDIA