Provider Demographics
NPI:1518088269
Name:JOHN P. HARRIS, D.DS. P.C.
Entity Type:Organization
Organization Name:JOHN P. HARRIS, D.DS. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:ADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-755-0991
Mailing Address - Street 1:427 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4314
Mailing Address - Country:US
Mailing Address - Phone:989-755-0991
Mailing Address - Fax:989-755-0001
Practice Address - Street 1:427 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4314
Practice Address - Country:US
Practice Address - Phone:989-755-0991
Practice Address - Fax:989-755-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010076541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty