Provider Demographics
NPI:1720213705
Name:THEODORE H. MORRIS JR DDS. PLLC
Entity Type:Organization
Organization Name:THEODORE H. MORRIS JR DDS. PLLC
Other - Org Name:MORRIS CENTER FOR DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-545-3363
Mailing Address - Street 1:7201 LEBANON ROAD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28227-9027
Mailing Address - Country:US
Mailing Address - Phone:704-545-3363
Mailing Address - Fax:704-545-0446
Practice Address - Street 1:7201 LEBANON ROAD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28227-9027
Practice Address - Country:US
Practice Address - Phone:704-545-3363
Practice Address - Fax:704-545-0446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-20
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty