Provider Demographics
NPI:1437553237
Name:TJ MORRIS DDS PC
Entity Type:Organization
Organization Name:TJ MORRIS DDS PC
Other - Org Name:ABIDE FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLINT
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOMEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-342-7781
Mailing Address - Street 1:517 GEORGIAN DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-3432
Mailing Address - Country:US
Mailing Address - Phone:251-342-7781
Mailing Address - Fax:251-342-7782
Practice Address - Street 1:517 GEORGIAN DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-3432
Practice Address - Country:US
Practice Address - Phone:251-342-7781
Practice Address - Fax:251-342-7782
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TJ MORRIS DDS PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL57501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty