Provider Demographics
NPI:1346639317
Name:DOUGLAS J. HARRINGTON,D.D.S.,A PROFESSIONAL DENTAL CORPORATION
Entity Type:Organization
Organization Name:DOUGLAS J. HARRINGTON,D.D.S.,A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-226-8508
Mailing Address - Street 1:118 NIBLICK RD
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-4842
Mailing Address - Country:US
Mailing Address - Phone:805-226-8508
Mailing Address - Fax:805-226-8576
Practice Address - Street 1:118 NIBLICK RD
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446-4842
Practice Address - Country:US
Practice Address - Phone:805-226-8508
Practice Address - Fax:805-226-8576
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-14
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435331223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty