Provider Demographics
NPI:1457469942
Name:MORRIS, SHAWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:
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 1:32363 ANN ARBOR TRAIL
Mailing Address - Street 2:
Mailing Address - City:WESTHAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-1470
Mailing Address - Country:US
Mailing Address - Phone:734-425-5580
Mailing Address - Fax:734-425-9340
Practice Address - Street 1:32363 ANN ARBOR TRAIL
Practice Address - Street 2:
Practice Address - City:WESTHAND
Practice Address - State:MI
Practice Address - Zip Code:48185-1470
Practice Address - Country:US
Practice Address - Phone:734-425-5580
Practice Address - Fax:734-425-9340
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist