Provider Demographics
NPI:1164843785
Name:JONATHAN A MORRIS DDS, PC
Entity Type:Organization
Organization Name:JONATHAN A MORRIS DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-299-4112
Mailing Address - Street 1:8218 WISCONSIN AVE STE 404
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3107
Mailing Address - Country:US
Mailing Address - Phone:301-299-4112
Mailing Address - Fax:301-299-4113
Practice Address - Street 1:8218 WISCONSIN AVE STE 404
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3107
Practice Address - Country:US
Practice Address - Phone:301-299-4112
Practice Address - Fax:301-299-4113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-27
Last Update Date:2013-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD127171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty