Provider Demographics
NPI:1114042736
Name:HARRE, PAULA L (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:L
Last Name:HARRE
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6825 S 27TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68512-4872
Mailing Address - Country:US
Mailing Address - Phone:402-489-8841
Mailing Address - Fax:402-489-1382
Practice Address - Street 1:6825 S 27TH ST STE 202
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68512-4872
Practice Address - Country:US
Practice Address - Phone:402-489-8841
Practice Address - Fax:402-489-1382
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE50581223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics