Provider Demographics
NPI:1740627900
Name:ROBERT D. MORRIS D.D.S.
Entity type:Organization
Organization Name:ROBERT D. MORRIS D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-232-3263
Mailing Address - Street 1:115 S FRUITRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-1643
Mailing Address - Country:US
Mailing Address - Phone:812-232-3263
Mailing Address - Fax:812-478-1401
Practice Address - Street 1:115 S FRUITRIDGE AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-1643
Practice Address - Country:US
Practice Address - Phone:812-232-3263
Practice Address - Fax:812-478-1401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006970A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty