Provider Demographics
NPI:1548396385
Name:MORRIS, THOMAS A (DMD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:MORRIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:A
Other - Last Name:MORRIS-ZAMORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:34 S BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:FL
Mailing Address - Zip Code:34266-3387
Mailing Address - Country:US
Mailing Address - Phone:863-993-1601
Mailing Address - Fax:863-491-7552
Practice Address - Street 1:34 S BALDWIN AVE
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:FL
Practice Address - Zip Code:34266
Practice Address - Country:US
Practice Address - Phone:863-993-1601
Practice Address - Fax:863-491-7552
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHAD 53122300000X
TX244491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1548396385Medicaid