Provider Demographics
NPI:1518259845
Name:HARVEY, BRIEN V (DDS MS)
Entity Type:Individual
Prefix:DR
First Name:BRIEN
Middle Name:V
Last Name:HARVEY
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 N WILMOT RD
Mailing Address - Street 2:E-2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1714
Mailing Address - Country:US
Mailing Address - Phone:520-745-5722
Mailing Address - Fax:520-745-2991
Practice Address - Street 1:899 N WILMOT RD
Practice Address - Street 2:E-2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1714
Practice Address - Country:US
Practice Address - Phone:520-745-5722
Practice Address - Fax:520-745-2991
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-04
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD36241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1962570630OtherNPI TYPE II