Healthcare Provider Details

I. General information

NPI: 1255440822
Provider Name (Legal Business Name): WINSTON CHARLES MORRIS DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US ARMY HOSPITAL HDENTAC CREDENTIALS OFFICE KARLSRUHESTR 144 NACHRICTEN KASERNE BLDG. 3607
HEIDELBERG BADEN WURTEMBOURG
69126
DE

IV. Provider business mailing address

US ARMY HOSPITALHDENTAC CREDENTIALS OFFICE KARLSRUHE STR 144 NACHRICTEN KASERNE BLDG. 3607
HEIDELBERG BADEN WURTEMBOURG
69126
DE

V. Phone/Fax

Practice location:
  • Phone: 622-117-2728
  • Fax:
Mailing address:
  • Phone: 622-117-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number4888
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: