Provider Demographics
NPI:1922110428
Name:MORRIS, MTIZI DEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:MTIZI
Middle Name:DEE
Last Name:MORRIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1295 HEMBREE RD
Mailing Address - Street 2:SUITE B-202
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-5721
Mailing Address - Country:US
Mailing Address - Phone:770-475-6767
Mailing Address - Fax:770-485-0493
Practice Address - Street 1:1295 HEMBREE RD
Practice Address - Street 2:SUITE B-202
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-5721
Practice Address - Country:US
Practice Address - Phone:770-475-6767
Practice Address - Fax:770-475-0493
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 011187122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist