Healthcare Provider Details

I. General information

NPI: 1154524486
Provider Name (Legal Business Name): CLAY SISSON MORRIS SR. DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

424 COMMERCIAL AVENUE
CLIFTON FORGE VA
24422
US

IV. Provider business mailing address

PO BOX 185
CLIFTON FORGE VA
24422
US

V. Phone/Fax

Practice location:
  • Phone: 540-862-4460
  • Fax: 540-862-4462
Mailing address:
  • Phone: 540-862-4460
  • Fax: 540-862-4462

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number0401007475
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: