Provider Demographics
NPI:1811294580
Name:MORRISON, JUSTIN L (DDS)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:L
Last Name:MORRISON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BAYOU BRANDT DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706
Mailing Address - Country:US
Mailing Address - Phone:409-866-3700
Mailing Address - Fax:409-866-1738
Practice Address - Street 1:10 BAYOU BRANDT DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706
Practice Address - Country:US
Practice Address - Phone:409-866-3700
Practice Address - Fax:409-866-1738
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-16
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX 25640122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist