Healthcare Provider Details

I. General information

NPI: 1457273674
Provider Name (Legal Business Name): SPENCER REED MORRISON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6871 DANIELS PKWY STE 100
FORT MYERS FL
33912-1510
US

IV. Provider business mailing address

4244 SE 20TH PL APT 120
CAPE CORAL FL
33904-5457
US

V. Phone/Fax

Practice location:
  • Phone: 239-288-0537
  • Fax:
Mailing address:
  • Phone: 660-254-0479
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN32177
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: