Provider Demographics
NPI:1629363155
Name:HARMON, DAVID ERVIN JR (DDS MSD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ERVIN
Last Name:HARMON
Suffix:JR
Gender:M
Credentials:DDS MSD
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Mailing Address - Street 1:10264 LAKE ARBOR WAY
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-3132
Mailing Address - Country:US
Mailing Address - Phone:301-333-3900
Mailing Address - Fax:301-333-3239
Practice Address - Street 1:10264 LAKE ARBOR WAY
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-3132
Practice Address - Country:US
Practice Address - Phone:301-333-3900
Practice Address - Fax:301-333-3239
Is Sole Proprietor?:No
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD118861223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics