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General NPI Number Information
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NPI Number | 1578645024
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Entity Type | Organization
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Legal Business Name | BOBBY MORRISON DDS & BARRY PENDERGRASS DDS, PLLC
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Dates
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Enumeration Date | 10/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1824 RAY MORRISON DR
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City | CENTERVILLE
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State | TN
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Zip | 37033-3000
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Country | US
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Telephone | 931-729-3356
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Fax | 931-729-7778
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Provider Business Mailing Address
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Address Line | 1824 RAY MORRISON DR
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City | CENTERVILLE
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State | TN
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Zip | 37033-3000
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Country | US
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Telephone | 931-729-3356
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Fax | 931-729-7778
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Authorized Official
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Title or Position | MEMBER
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Name | BOBBY R MORRISON
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Credential | DDS
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Telephone | 931-729-3356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DS3110
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License Number State | TN
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