MEDICARE: DR. ROBERT JACKSON MORRIS DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	2123	SC

General Provider Information

NPI Number	:	1912074634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JACKSON MORRIS DMD

Provider Business Mailing Address
First Line	:	211 SIMMONS ST
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-4347
Country	:	US
Telephone Number	:	843-884-5161
Fax Number	:	843-884-6585

Provider Business Practice Location Address
First Line	:	211 SIMMONS ST
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-4347
Country	:	US
Telephone Number	:	843-884-5161
Fax Number	:	843-884-6585

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	01/11/2026

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