Provider Demographics
NPI:1093932980
Name:MORRISON, SCOTT L (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:L
Last Name:MORRISON
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 N 129TH ST # 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-6107
Mailing Address - Country:US
Mailing Address - Phone:402-431-8688
Mailing Address - Fax:402-492-9782
Practice Address - Street 1:624 N 129TH ST # 200
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-6107
Practice Address - Country:US
Practice Address - Phone:402-431-8688
Practice Address - Fax:402-492-9782
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE53461223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics