Provider Demographics
NPI:1508095647
Name:GARRE, HARISH (DMD)
Entity Type:Individual
Prefix:
First Name:HARISH
Middle Name:
Last Name:GARRE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:138 NORTHAMPTON ST APT D
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1854
Mailing Address - Country:US
Mailing Address - Phone:617-755-2257
Mailing Address - Fax:
Practice Address - Street 1:138 NORTHAMPTON ST
Practice Address - Street 2:APT D
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-1854
Practice Address - Country:US
Practice Address - Phone:617-755-2257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18552131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice