Provider Demographics
NPI:1386850188
Name:R. HARRIS DANIEL, D.D.S.
Entity Type:Organization
Organization Name:R. HARRIS DANIEL, D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:HARRIS
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-697-0618
Mailing Address - Street 1:5706 MCLEANSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MC LEANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27301-9303
Mailing Address - Country:US
Mailing Address - Phone:336-697-0618
Mailing Address - Fax:336-697-9478
Practice Address - Street 1:5706 MCLEANSVILLE RD
Practice Address - Street 2:
Practice Address - City:MC LEANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27301-9303
Practice Address - Country:US
Practice Address - Phone:336-697-0618
Practice Address - Fax:336-697-9478
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4477122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty