Provider Demographics
NPI:1508982083
Name:HARMON, JOHN JARED (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JARED
Last Name:HARMON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 VILLAGE ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-5354
Mailing Address - Country:US
Mailing Address - Phone:985-643-4600
Mailing Address - Fax:985-643-9338
Practice Address - Street 1:102 VILLAGE ST
Practice Address - Street 2:SUITE B
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-5354
Practice Address - Country:US
Practice Address - Phone:985-643-4600
Practice Address - Fax:985-643-9338
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics