Provider Demographics
NPI:1659648541
Name:GREEN-MORRISON, HEATHER CULLEEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:CULLEEN
Last Name:GREEN-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 1:12810 W 119TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-2374
Mailing Address - Country:US
Mailing Address - Phone:312-493-4613
Mailing Address - Fax:
Practice Address - Street 1:12125 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66216-1829
Practice Address - Country:US
Practice Address - Phone:913-469-9191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-21
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS610591223X0400X
NY054801122300000X
MO20140341971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist