Provider Demographics
NPI:1679678551
Name:MORRIS, DARRYL L (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRYL
Middle Name:L
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:10165 FOOTHILL BLVD STE 23
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-0342
Mailing Address - Country:US
Mailing Address - Phone:909-481-9500
Mailing Address - Fax:909-481-9502
Practice Address - Street 1:10165 FOOTHILL BLVD STE 23
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-0342
Practice Address - Country:US
Practice Address - Phone:909-481-9500
Practice Address - Fax:909-481-9502
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGA12621223S0112X
CA500801223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery