Provider Demographics
NPI:1639765019
Name:MORRISON DENTAL, PLLC
Entity Type:Organization
Organization Name:MORRISON DENTAL, PLLC
Other - Org Name:MARKET RIDGE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:BLAIR
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-660-7242
Mailing Address - Street 1:21023 MARKET RDG STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4975
Mailing Address - Country:US
Mailing Address - Phone:210-960-2690
Mailing Address - Fax:
Practice Address - Street 1:21023 MARKET RDG
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4975
Practice Address - Country:US
Practice Address - Phone:210-660-7242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty