Provider Demographics
NPI:1619173531
Name:HARRISON, WILLIAM HENRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:HARRISON
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 1:3233 GRAND AVE
Mailing Address - Street 2:SUIRE E
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1489
Mailing Address - Country:US
Mailing Address - Phone:909-682-7100
Mailing Address - Fax:909-591-6640
Practice Address - Street 1:3233 GRAND AVE
Practice Address - Street 2:SUIRE E
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1489
Practice Address - Country:US
Practice Address - Phone:909-682-7100
Practice Address - Fax:909-591-6640
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA289331223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics