Healthcare Provider Details

I. General information

NPI: 1467502633
Provider Name (Legal Business Name): RICHARD B MORRISON, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 10/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E. MAIN ST.
PICKFORD MI
49774
US

IV. Provider business mailing address

PO BOX 308 205 E MAIN STREET
PICKFORD MI
49774-0308
US

V. Phone/Fax

Practice location:
  • Phone: 906-647-9201
  • Fax:
Mailing address:
  • Phone: 906-647-9201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. RICHARD MORRISON
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 906-647-9201