Provider Demographics
NPI:1235832510
Name:NIXA DENTAL PARTNERS, LLC
Entity Type:Organization
Organization Name:NIXA DENTAL PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-342-8222
Mailing Address - Street 1:729 W CENTER CIR STE 104
Mailing Address - Street 2:
Mailing Address - City:NIXA
Mailing Address - State:MO
Mailing Address - Zip Code:65714-7027
Mailing Address - Country:US
Mailing Address - Phone:417-595-4470
Mailing Address - Fax:
Practice Address - Street 1:729 W CENTER CIR STE 104
Practice Address - Street 2:
Practice Address - City:NIXA
Practice Address - State:MO
Practice Address - Zip Code:65714-7027
Practice Address - Country:US
Practice Address - Phone:417-595-4470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARR FAMILY DENTAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-03-24
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty