Provider Demographics
NPI:1942322961
Name:MORRIS, EDWIN LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:LAWRENCE
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4211 BLAKELY AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21236-2407
Mailing Address - Country:US
Mailing Address - Phone:410-256-2044
Mailing Address - Fax:410-256-6675
Practice Address - Street 1:4211 BLAKELY AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21236-2407
Practice Address - Country:US
Practice Address - Phone:410-256-2044
Practice Address - Fax:410-256-6675
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD56671223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics