MEDICARE: TIMOTHY A MORRIS DDS INC

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	122300000X	Dentist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669644530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TIMOTHY A MORRIS DDS INC

Provider Business Mailing Address
First Line	:	2223 FULTON RD NW
Second Line	:	SUITE 201
City	:	CANTON
State	:	OH
Zip	:	44709-3554
Country	:	US
Telephone Number	:	330-455-7613
Fax Number	:	330-455-1920

Provider Business Practice Location Address
First Line	:	2223 FULTON RD NW
Second Line	:	SUITE 201
City	:	CANTON
State	:	OH
Zip	:	44709-3554
Country	:	US
Telephone Number	:	330-455-7613
Fax Number	:	330-455-1920

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TIMOTHY ANDREW MORRIS
Credential	:	DDS
Telephone Number	:	330-455-7613

Provider Enumeration Date	:	03/31/2008
Last Update Date	:	08/06/2008

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