Provider Demographics
NPI:1558332262
Name:HARB, FREDERICK ALEXANDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:ALEXANDER
Last Name:HARB
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 1:833 S WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48186-4303
Mailing Address - Country:US
Mailing Address - Phone:734-722-0500
Mailing Address - Fax:734-722-1196
Practice Address - Street 1:833 S WAYNE RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48186-4303
Practice Address - Country:US
Practice Address - Phone:734-722-0500
Practice Address - Fax:734-722-1196
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI16938122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist