Provider Demographics
NPI:1366675613
Name:NORA K. HARMSEN, D.D.S., INC.
Entity Type:Organization
Organization Name:NORA K. HARMSEN, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NORA
Authorized Official - Middle Name:K
Authorized Official - Last Name:HARMSEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-565-6418
Mailing Address - Street 1:PO BOX 630069
Mailing Address - Street 2:
Mailing Address - City:LANAI CITY
Mailing Address - State:HI
Mailing Address - Zip Code:96763-0069
Mailing Address - Country:US
Mailing Address - Phone:808-565-6418
Mailing Address - Fax:808-565-6742
Practice Address - Street 1:730 LANAI AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:LANAI CITY
Practice Address - State:HI
Practice Address - Zip Code:96763-0069
Practice Address - Country:US
Practice Address - Phone:808-565-6418
Practice Address - Fax:808-565-6742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT1969261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIDT1969Medicaid