Provider Demographics
NPI:1093051534
Name:ZACHARY J. HARRISON DDS, PA
Entity Type:Organization
Organization Name:ZACHARY J. HARRISON DDS, PA
Other - Org Name:HARRISON FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:JOEL
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-792-7011
Mailing Address - Street 1:PO BOX 1125
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-1125
Mailing Address - Country:US
Mailing Address - Phone:252-792-7011
Mailing Address - Fax:252-809-4815
Practice Address - Street 1:1025 HARRISWAY DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-8683
Practice Address - Country:US
Practice Address - Phone:252-792-7011
Practice Address - Fax:252-809-4815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC87651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty