Provider Demographics
NPI:1184851362
Name:MORRISON DENTAL ASSOCIATES PC
Entity Type:Organization
Organization Name:MORRISON DENTAL ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MONTEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-235-3610
Mailing Address - Street 1:6602 ABERCORN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-5827
Mailing Address - Country:US
Mailing Address - Phone:912-354-3444
Mailing Address - Fax:912-354-3841
Practice Address - Street 1:6602 ABERCORN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-5827
Practice Address - Country:US
Practice Address - Phone:912-354-3444
Practice Address - Fax:912-354-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-16
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA6627200001Medicare NSC