Provider Demographics
NPI:1407806789
Name:BEVERLY T MORRIS DDS PC
Entity Type:Organization
Organization Name:BEVERLY T MORRIS DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:L
Authorized Official - Last Name:JUSTICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-692-0102
Mailing Address - Street 1:24201 MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-2134
Mailing Address - Country:US
Mailing Address - Phone:734-692-0102
Mailing Address - Fax:734-692-1541
Practice Address - Street 1:24201 MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:GROSSE ILE
Practice Address - State:MI
Practice Address - Zip Code:48138-2134
Practice Address - Country:US
Practice Address - Phone:734-692-0102
Practice Address - Fax:734-692-1541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2011-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty