Provider Demographics
NPI:1235250689
Name:MORRIS, KEITH D (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:D
Last Name:MORRIS
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 1:8089 WALNUT RUN RD
Mailing Address - Street 2:#1
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-8843
Mailing Address - Country:US
Mailing Address - Phone:901-753-0071
Mailing Address - Fax:901-756-5691
Practice Address - Street 1:8089 WALNUT RUN RD
Practice Address - Street 2:#1
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8843
Practice Address - Country:US
Practice Address - Phone:901-753-0071
Practice Address - Fax:901-756-5691
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS73331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice