Provider Demographics
NPI:1902972482
Name:MORRIS, STEPHEN TRACY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:TRACY
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 SOUTH SUMMIT AVE.
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-1023
Mailing Address - Country:US
Mailing Address - Phone:817-335-3993
Mailing Address - Fax:817-335-3996
Practice Address - Street 1:425 S SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-1023
Practice Address - Country:US
Practice Address - Phone:817-335-3993
Practice Address - Fax:817-335-3996
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice