Provider Demographics
NPI:1790128825
Name:MORRISON, RYAN CARL (DMD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:CARL
Last Name:MORRISON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 WILD FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-6748
Mailing Address - Country:US
Mailing Address - Phone:601-431-9886
Mailing Address - Fax:
Practice Address - Street 1:1516 SKYLAND BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-4232
Practice Address - Country:US
Practice Address - Phone:601-431-9886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL60681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice