Provider Demographics
NPI:1770653263
Name:MORRISON DENTAL COSMETIC LLC
Entity Type:Organization
Organization Name:MORRISON DENTAL COSMETIC LLC
Other - Org Name:MIDTOWN DENTAL STUDIO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-931-6750
Mailing Address - Street 1:1545 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 275
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309
Mailing Address - Country:US
Mailing Address - Phone:404-870-9662
Mailing Address - Fax:404-870-9664
Practice Address - Street 1:1545 PEACHTREE ST NE
Practice Address - Street 2:SUITE 275
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-870-9662
Practice Address - Fax:404-870-9664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty