Provider Demographics
NPI:1932650140
Name:MORRIS, FELICIA (RDH)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:MORRIS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:FELICIA
Other - Middle Name:
Other - Last Name:ROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:15503 OAK LN STE 300-B
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-2697
Mailing Address - Country:US
Mailing Address - Phone:228-832-3231
Mailing Address - Fax:228-832-0186
Practice Address - Street 1:15503 OAK LN STE 300-B
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-2697
Practice Address - Country:US
Practice Address - Phone:228-832-3231
Practice Address - Fax:228-832-0186
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3869-10DH124Q00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No124Q00000XDental ProvidersDental Hygienist