Healthcare Provider Details

I. General information

NPI: 1699741165
Provider Name (Legal Business Name): ISAIAH PURNELL MORRISON III D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3863 ALABAMA AVE. SE
WASHINGTON DC
20020
US

IV. Provider business mailing address

3863 ALABAMA AVE. SE
WASHINGTON DC
20020
US

V. Phone/Fax

Practice location:
  • Phone: 202-889-8200
  • Fax: 202-889-5891
Mailing address:
  • Phone: 202-889-8200
  • Fax: 202-889-5891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN3054
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: