Provider Demographics
NPI:1336496934
Name:HARVEY, RACHEL SAWYER (DDS)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:SAWYER
Last Name:HARVEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 N MCCREARY ST
Mailing Address - Street 2:
Mailing Address - City:FORT BRANCH
Mailing Address - State:IN
Mailing Address - Zip Code:47648-1313
Mailing Address - Country:US
Mailing Address - Phone:812-753-1039
Mailing Address - Fax:
Practice Address - Street 1:123 N MCCREARY ST
Practice Address - Street 2:
Practice Address - City:FORT BRANCH
Practice Address - State:IN
Practice Address - Zip Code:47648-1313
Practice Address - Country:US
Practice Address - Phone:812-753-1039
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2013-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011850A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice