Provider Demographics
NPI:1568957660
Name:HARMON, TORI LYNN (DDS)
Entity Type:Individual
Prefix:
First Name:TORI
Middle Name:LYNN
Last Name:HARMON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1337 E 900 N
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-7320
Mailing Address - Country:US
Mailing Address - Phone:765-376-4915
Mailing Address - Fax:
Practice Address - Street 1:2111 330TH AVE
Practice Address - Street 2:
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-9783
Practice Address - Country:US
Practice Address - Phone:543-231-9372
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-30
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012928A1223G0001X
IADDS-09608122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice