Provider Demographics
NPI:1548378391
Name:HARMON, JON D SR (DDS)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:D
Last Name:HARMON
Suffix:SR
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 1:1314 S EUCLID ST
Mailing Address - Street 2:SUITE #206
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92802
Mailing Address - Country:US
Mailing Address - Phone:714-635-1021
Mailing Address - Fax:714-635-1136
Practice Address - Street 1:1314 S EUCLID ST
Practice Address - Street 2:SUITE #206
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92802
Practice Address - Country:US
Practice Address - Phone:714-635-1021
Practice Address - Fax:714-635-1136
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist