Provider Demographics
NPI:1497902514
Name:MICHAEL STEPHEN HARRISON, JR, D.D.S. P.A.
Entity Type:Organization
Organization Name:MICHAEL STEPHEN HARRISON, JR, D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:STEPHEN
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-984-6400
Mailing Address - Street 1:PO BOX 8039
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:71910-8039
Mailing Address - Country:US
Mailing Address - Phone:501-984-6400
Mailing Address - Fax:501-984-4107
Practice Address - Street 1:4419 N HIGHWAY 7
Practice Address - Street 2:STE. 301
Practice Address - City:HOT SPRINGS VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:71909-9301
Practice Address - Country:US
Practice Address - Phone:501-984-6400
Practice Address - Fax:501-984-4107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-20
Last Update Date:2008-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3552261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental