Provider Demographics
NPI:1942629100
Name:MORRIS, STEPHANIE FAYE (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:FAYE
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 1:273 MALLARD POINT DR APT 205
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-5725
Mailing Address - Country:US
Mailing Address - Phone:330-620-9736
Mailing Address - Fax:
Practice Address - Street 1:4322 CLEVELAND MASSILLON RD STE 3
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:OH
Practice Address - Zip Code:44203-5718
Practice Address - Country:US
Practice Address - Phone:330-825-4549
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0241931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice