Provider Demographics
NPI:1386859098
Name:MORRIS, STEPHEN A (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:A
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:140 E BOISE AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83706-4373
Mailing Address - Country:US
Mailing Address - Phone:208-344-4334
Mailing Address - Fax:208-381-0450
Practice Address - Street 1:140 E BOISE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-4373
Practice Address - Country:US
Practice Address - Phone:208-344-4334
Practice Address - Fax:208-381-0450
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IDD-1998-OR1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics