Provider Demographics
NPI:1912070186
Name:MORROW, ROBERT LEON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LEON
Last Name:MORROW
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:BOB
Other - Middle Name:LEON
Other - Last Name:MORROW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:WALSH
Mailing Address - State:CO
Mailing Address - Zip Code:81090-0070
Mailing Address - Country:US
Mailing Address - Phone:719-324-5251
Mailing Address - Fax:719-324-5621
Practice Address - Street 1:137 KANSAS ST
Practice Address - Street 2:
Practice Address - City:WALSH
Practice Address - State:CO
Practice Address - Zip Code:81090
Practice Address - Country:US
Practice Address - Phone:719-324-5251
Practice Address - Fax:719-324-5621
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COHD1047551223G0001X
KS602171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
COA02047553Medicaid