Provider Demographics
NPI:1477048411
Name:MORRISON, LAUREN A (DDS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:A
Last Name:MORRISON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22561 BERTRAM DR
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-3737
Mailing Address - Country:US
Mailing Address - Phone:810-358-5225
Mailing Address - Fax:
Practice Address - Street 1:820 BYRON RD STE 800
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-1072
Practice Address - Country:US
Practice Address - Phone:517-546-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1001847-15122300000X
MI29016009711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist