Provider Demographics
NPI:1477092997
Name:HARRIS DENTAL ASSOCIATES HDA PC
Entity Type:Organization
Organization Name:HARRIS DENTAL ASSOCIATES HDA PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-584-6070
Mailing Address - Street 1:348 N PEARL ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-1197
Mailing Address - Country:US
Mailing Address - Phone:508-584-6070
Mailing Address - Fax:877-802-8570
Practice Address - Street 1:348 N PEARL ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-1197
Practice Address - Country:US
Practice Address - Phone:508-584-6070
Practice Address - Fax:877-802-8570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty