Provider Demographics
NPI:1164249157
Name:MORGAN CLAY MORRISON BA, MS, DMD PLLC
Entity type:Organization
Organization Name:MORGAN CLAY MORRISON BA, MS, DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:CLAY
Authorized Official - Last Name:MORRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-770-2225
Mailing Address - Street 1:1515 INDIAN RIVER BLVD STE A140
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-7106
Mailing Address - Country:US
Mailing Address - Phone:772-770-2225
Mailing Address - Fax:772-770-6062
Practice Address - Street 1:1515 INDIAN RIVER BLVD STE A140
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7106
Practice Address - Country:US
Practice Address - Phone:772-770-2225
Practice Address - Fax:772-770-6062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1164952792OtherMORGAN CLAY MORRISON PROVIDER NPI NUMBER
1457394447OtherCARL JEFFREY CLAY PROVIDER NPI NUMBER
FLDN20140OtherCARL JEFFREY CLAY DENTAL LICENSE
FLDN22738OtherMORGAN CLAY MORRISON DENTAL LICENSE