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General NPI Number Information
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NPI Number | 1659648541
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Entity Type | Individual
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Provider Name | HEATHER CULLEEN GREEN-MORRISON D.D.S
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Gender | Female
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Dates
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Enumeration Date | 11/21/2011
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 12125 SHAWNEE MISSION PKWY
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City | SHAWNEE
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State | KS
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Zip | 66216-1829
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Country | US
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Telephone | 913-469-9191
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Fax |
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Provider Business Mailing Address
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Address Line | 12810 W 119TH TER
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City | OVERLAND PARK
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State | KS
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Zip | 66213-2374
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Country | US
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Telephone | 312-493-4613
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 61059
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 054801
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2014034197
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License Number State | MO
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