Provider Demographics
NPI:1326255241
Name:MORRIS, RYAN D (DDS)
Entity Type:Individual
Prefix:
First Name:RYAN
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 1:3950 VETERANS DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-3424
Mailing Address - Country:US
Mailing Address - Phone:320-252-3611
Mailing Address - Fax:320-252-7574
Practice Address - Street 1:3950 VETERANS DR STE 100
Practice Address - Street 2:
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-3424
Practice Address - Country:US
Practice Address - Phone:320-252-3611
Practice Address - Fax:320-252-7574
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND127601223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery