Healthcare Provider Details

I. General information

NPI: 1437271491
Provider Name (Legal Business Name): CHRISTA E. MORRIS, DDS & ASSOC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 03/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10160 SUPERIOR WAY
AMELIA COURT HOUSE VA
23002-4744
US

IV. Provider business mailing address

10160 SUPERIOR WAY
AMELIA COURT HOUSE VA
23002-4744
US

V. Phone/Fax

Practice location:
  • Phone: 804-561-4379
  • Fax: 804-561-2019
Mailing address:
  • Phone: 804-561-4379
  • Fax: 804-561-2019

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number0401008984
License Number StateVA

VIII. Authorized Official

Name: CHRISTA E. MORRIS
Title or Position: OWNER
Credential: DDS
Phone: 804-561-4379