Provider Demographics
NPI:1083952063
Name:JOHN D HARKER DDS LLC
Entity Type:Organization
Organization Name:JOHN D HARKER DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HARKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:812-546-4057
Mailing Address - Street 1:9909 N STATE ROAD 9
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:IN
Mailing Address - Zip Code:47246-8700
Mailing Address - Country:US
Mailing Address - Phone:812-546-4057
Mailing Address - Fax:812-546-5653
Practice Address - Street 1:9909 N STATE ROAD 9
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:IN
Practice Address - Zip Code:47246-8700
Practice Address - Country:US
Practice Address - Phone:812-546-4057
Practice Address - Fax:812-546-5653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-25
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006884122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty