Provider Demographics
NPI:1467548776
Name:HARRISON, KEVIN ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:ARTHUR
Last Name:HARRISON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16410 SMOKEY POINT BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223
Mailing Address - Country:US
Mailing Address - Phone:360-653-7654
Mailing Address - Fax:360-658-1070
Practice Address - Street 1:16410 SMOKEY POINT BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223
Practice Address - Country:US
Practice Address - Phone:360-653-7654
Practice Address - Fax:360-658-1070
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0005577122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist