Provider Demographics
NPI:1336360395
Name:MORRIS, MICHAEL LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LYNN
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ENTERPRISE AVE
Mailing Address - Street 2:200
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-3082
Mailing Address - Country:US
Mailing Address - Phone:281-535-5550
Mailing Address - Fax:281-535-9577
Practice Address - Street 1:201 ENTERPRISE AVE
Practice Address - Street 2:200
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3082
Practice Address - Country:US
Practice Address - Phone:281-535-5550
Practice Address - Fax:281-535-9577
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX98131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice