Provider Demographics
NPI:1285626564
Name:MORRISON, HONG MINH (DDS)
Entity Type:Individual
Prefix:
First Name:HONG
Middle Name:MINH
Last Name:MORRISON
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 1:30 CAMINO VEGA VERDE
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-8529
Mailing Address - Country:US
Mailing Address - Phone:505-449-7416
Mailing Address - Fax:505-896-1828
Practice Address - Street 1:2401 CABEZON BLVD SE STE 101
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-1513
Practice Address - Country:US
Practice Address - Phone:505-896-8862
Practice Address - Fax:505-896-1828
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD25121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice