Healthcare Provider Details

I. General information

NPI: 1497090930
Provider Name (Legal Business Name): JANE MARGARET MORRIS R.D.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2012
Last Update Date: 12/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 RUBIN DR
RUSHVILLE NY
14544-9681
US

IV. Provider business mailing address

259 MONROE AVE
ROCHESTER NY
14607-3632
US

V. Phone/Fax

Practice location:
  • Phone: 585-554-4400
  • Fax:
Mailing address:
  • Phone: 585-325-2280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number018715
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: