Provider Demographics
NPI:1437326469
Name:BRYAN F. HARJU, DMD INC.
Entity Type:Organization
Organization Name:BRYAN F. HARJU, DMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:HARJU
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:937-339-5782
Mailing Address - Street 1:435 TRADE SQ W
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-2461
Mailing Address - Country:US
Mailing Address - Phone:937-339-5782
Mailing Address - Fax:937-339-7690
Practice Address - Street 1:435 TRADE SQ W
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2461
Practice Address - Country:US
Practice Address - Phone:937-339-5782
Practice Address - Fax:937-339-7690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21429261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental