Provider Demographics
NPI:1578650958
Name:HARRELL,JR., JAMES ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ANDREW
Last Name:HARRELL,JR.
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 1:835 CLAREMONT CENTER DR
Mailing Address - Street 2:
Mailing Address - City:ELKIN
Mailing Address - State:NC
Mailing Address - Zip Code:28621-2488
Mailing Address - Country:US
Mailing Address - Phone:336-835-3337
Mailing Address - Fax:336-835-1241
Practice Address - Street 1:835 CLAREMONT CENTER DR
Practice Address - Street 2:
Practice Address - City:ELKIN
Practice Address - State:NC
Practice Address - Zip Code:28621-2488
Practice Address - Country:US
Practice Address - Phone:336-835-3337
Practice Address - Fax:336-835-1241
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice