Provider Demographics
NPI:1750546669
Name:BOBBIE N MORRIS DDS LLC
Entity type:Organization
Organization Name:BOBBIE N MORRIS DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:985-532-3480
Mailing Address - Street 1:707 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:LOCKPORT
Mailing Address - State:LA
Mailing Address - Zip Code:70374-2815
Mailing Address - Country:US
Mailing Address - Phone:985-532-3480
Mailing Address - Fax:985-532-0268
Practice Address - Street 1:707 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:LOCKPORT
Practice Address - State:LA
Practice Address - Zip Code:70374-2815
Practice Address - Country:US
Practice Address - Phone:985-532-3480
Practice Address - Fax:985-532-0268
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOBBIE N MORRIS DDS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-21
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4092305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization