Provider Demographics
NPI:1376001818
Name:MORRIS DENTAL, LLC
Entity Type:Organization
Organization Name:MORRIS DENTAL, LLC
Other - Org Name:MISS LOU DENTAL CREEKSIDE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:C0-OWNER
Authorized Official - Phone:337-258-8601
Mailing Address - Street 1:101 HIGHWAY 61 S
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120-5216
Mailing Address - Country:US
Mailing Address - Phone:601-446-9099
Mailing Address - Fax:601-844-0938
Practice Address - Street 1:101 HIGHWAY 61 S
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120-5216
Practice Address - Country:US
Practice Address - Phone:601-446-9099
Practice Address - Fax:601-844-0938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty