Provider Demographics
NPI:1366843237
Name:HARRIMAN, ERIK JUEL (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:JUEL
Last Name:HARRIMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4420
Mailing Address - Country:US
Mailing Address - Phone:407-932-0883
Mailing Address - Fax:407-932-4251
Practice Address - Street 1:200 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4420
Practice Address - Country:US
Practice Address - Phone:407-932-0883
Practice Address - Fax:407-932-4251
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600359122300000X
PADS040138122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist