Provider Demographics
NPI:1851342117
Name:MORRIS, BEVERLY TAYLOR (DDS)
Entity Type:Individual
Prefix:MRS
First Name:BEVERLY
Middle Name:TAYLOR
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26459 E RIVER RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1853
Mailing Address - Country:US
Mailing Address - Phone:734-675-0476
Mailing Address - Fax:734-692-1541
Practice Address - Street 1:24201 MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:GROSSE ILE
Practice Address - State:MI
Practice Address - Zip Code:48138-2134
Practice Address - Country:US
Practice Address - Phone:734-692-0102
Practice Address - Fax:734-692-1541
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBM03768891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice