Provider Demographics
NPI:1578776266
Name:HARRINGTON, JACK L (DDS)
Entity Type:Individual
Prefix:
First Name:JACK
Middle Name:L
Last Name:HARRINGTON
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:PO BOX 10408
Mailing Address - Street 2:
Mailing Address - City:ZEPHYR COVE
Mailing Address - State:NV
Mailing Address - Zip Code:89448-2408
Mailing Address - Country:US
Mailing Address - Phone:775-588-5183
Mailing Address - Fax:
Practice Address - Street 1:3790 HIGHWAY 395
Practice Address - Street 2:SUTIE 103
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89448
Practice Address - Country:US
Practice Address - Phone:775-265-4411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV8681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice