Provider Demographics
NPI:1760711626
Name:MORRISON, MICHAEL WILLIAM (DDS, MSD,)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:WILLIAM
Last Name:MORRISON
Suffix:
Gender:M
Credentials:DDS, MSD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9006 OHIO ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-6139
Mailing Address - Country:US
Mailing Address - Phone:402-397-4443
Mailing Address - Fax:719-397-4443
Practice Address - Street 1:9006 OHIO ST
Practice Address - Street 2:SUITE 3
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-6139
Practice Address - Country:US
Practice Address - Phone:402-397-4443
Practice Address - Fax:719-397-4443
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-23
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE63661223X0400X
CO90971223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics