MEDICARE: RICHARD B MORRISON, D.D.S., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D800167	OTHER	MI	MI BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467502633
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD B MORRISON, D.D.S., P.C.

Provider Business Mailing Address
First Line	:	PO BOX 308
Second Line	:	205 E MAIN STREET
City	:	PICKFORD
State	:	MI
Zip	:	49774-0308
Country	:	US
Telephone Number	:	906-647-9201
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 E. MAIN ST.
Second Line	:
City	:	PICKFORD
State	:	MI
Zip	:	49774
Country	:	US
Telephone Number	:	906-647-9201
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICHARD MORRISON
Credential	:	D.D.S.
Telephone Number	:	906-647-9201

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	10/04/2007

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