Provider Demographics
NPI:1578103867
Name:HARMONI DENTAL CLINIC, LLC
Entity Type:Organization
Organization Name:HARMONI DENTAL CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:COONEY
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:470-408-5161
Mailing Address - Street 1:1421 PEACHTREE ST NE STE A
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3040
Mailing Address - Country:US
Mailing Address - Phone:470-408-5161
Mailing Address - Fax:
Practice Address - Street 1:1421 PEACHTREE ST NE STE A
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3040
Practice Address - Country:US
Practice Address - Phone:470-408-5161
Practice Address - Fax:470-300-0056
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HARMONI COMPLETE CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-01-14
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty