Provider Demographics
NPI:1063449684
Name:HARRIS, JOEL TRION (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:TRION
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JOLIE
Other - Middle Name:TRION
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1403 DEREK DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-5768
Mailing Address - Country:US
Mailing Address - Phone:985-345-5856
Mailing Address - Fax:985-345-5856
Practice Address - Street 1:1403 DEREK DR
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5768
Practice Address - Country:US
Practice Address - Phone:985-345-5856
Practice Address - Fax:985-345-5856
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA3966122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist