=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043373293
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HENRY ROSS MORRISON DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/19/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17000 E 40 HWY SUITE 6
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64055-5394
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-373-8282
-----------------------------------------------------
Fax | 816-373-8274
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 17000 E 40 HWY SUITE 6
-----------------------------------------------------
City | INDEPENDENCE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 64055-5394
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 816-373-8282
-----------------------------------------------------
Fax | 816-373-8274
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 015052
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------