Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 5346 | NE |
NPI | 1093932980 |
---|---|
Provider Name | Dr. Scott L Morrison |
First Address | Omaha, NE 68154-6107 |
Second Address | Omaha, NE 68154-6107 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2007 |
Last Update Date | 08/07/2007 |