Provider Demographics
NPI:1568748911
Name:HARKER, CORY CAMERON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:CAMERON
Last Name:HARKER
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 1:1250 W IRONWOOD DR STE 216
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2681
Mailing Address - Country:US
Mailing Address - Phone:208-667-4844
Mailing Address - Fax:208-292-0743
Practice Address - Street 1:1250 W IRONWOOD DR STE 216
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2681
Practice Address - Country:US
Practice Address - Phone:208-667-4844
Practice Address - Fax:208-292-0743
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-43951223G0001X
WADE 602514551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice