Provider Demographics
NPI:1003097478
Name:HARRIS, WINIFRED JONES (DMD)
Entity Type:Individual
Prefix:
First Name:WINIFRED
Middle Name:JONES
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:JONES
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:212 PROMINENCE CT
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-6276
Mailing Address - Country:US
Mailing Address - Phone:706-216-7777
Mailing Address - Fax:706-216-6478
Practice Address - Street 1:212 PROMINENCE CT
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-6276
Practice Address - Country:US
Practice Address - Phone:706-216-7777
Practice Address - Fax:706-216-6478
Is Sole Proprietor?:No
Enumeration Date:2007-11-14
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0115861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice