Provider Demographics
NPI:1619385358
Name:HAREESH DENTAL CORPORATION
Entity Type:Organization
Organization Name:HAREESH DENTAL CORPORATION
Other - Org Name:PERRIS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HAREESH
Authorized Official - Middle Name:
Authorized Official - Last Name:VEERABHADRAIAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-943-4007
Mailing Address - Street 1:391 WILKERSON AVE STE A&B
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-2254
Mailing Address - Country:US
Mailing Address - Phone:951-943-4007
Mailing Address - Fax:951-943-1037
Practice Address - Street 1:391 WILKERSON AVE STE A&B
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2254
Practice Address - Country:US
Practice Address - Phone:951-943-4007
Practice Address - Fax:951-943-1037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-25
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty