Palouse Oral & Maxillofacial Surgery

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D-3321-OS Issued in ID

Legal business name

PALOUSE ORAL & MAXILLOFACIAL SURGERY

Practice address

2301 W a St
Suite a
Moscow, ID 83843-4042

Phone

(208) 882-0331

NPI assigned

Nov 30, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Wallace Morrisn, D.M.D.

Title

Owner

Phone

(208) 882-0331

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1259539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259539200000",
    "number": "1497083638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 W A ST",
            "address_2": "SUITE A",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838434042",
            "telephone_number": "208-882-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W A ST",
            "address_2": "SUITE A",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838434042",
            "telephone_number": "208-882-0331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALOUSE ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-30",
        "last_updated": "2009-11-30",
        "status": "A",
        "authorized_official_last_name": "MORRISN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-882-0331",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ID",
            "license": "D-3321-OS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI-PERSONAL",
            "identifier": "1164567913",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palouse Area Care & Transport
• Palouse Area Care & Transport, LLC
• Palouse Foot & Ankle Clinic
• Palouse Holistic Health & Aesthetics
• Palouse Imaging Consultants, PLLC
• Palouse Pediatric Dentistry
• Palouse Pelvic Rehabilitation & Physical Therapy, PLLC
• Palouse Prairie Educational Organization
• Palouse Specialty Physicians, P.S.
• Palouse Specialty Physicians, P.S.

• Dental Clinic/Center in Moscow, ID
• Providers in Moscow, ID by specialty
• Dental Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.