Provider Demographics
NPI:1164439444
Name:HARRIS, R GARTH (DDS)
Entity Type:Individual
Prefix:DR
First Name:R GARTH
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:RODNEY
Other - Middle Name:GARTH
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:9777 BERMUDA RD
Mailing Address - Street 2:STE 100
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89183-3571
Mailing Address - Country:US
Mailing Address - Phone:702-699-5551
Mailing Address - Fax:702-914-9019
Practice Address - Street 1:9777 BERMUDA RD STE 100
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89183-3571
Practice Address - Country:US
Practice Address - Phone:702-324-0404
Practice Address - Fax:702-914-9019
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV32081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice