Provider Demographics
NPI:1639850183
Name:HARRIS HOMETOWN DENTISTRY PLLC
Entity Type:Organization
Organization Name:HARRIS HOMETOWN DENTISTRY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:423-762-5263
Mailing Address - Street 1:180 WALNUT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TN
Mailing Address - Zip Code:37321-5939
Mailing Address - Country:US
Mailing Address - Phone:423-762-5263
Mailing Address - Fax:
Practice Address - Street 1:180 WALNUT GROVE RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:TN
Practice Address - Zip Code:37321-5939
Practice Address - Country:US
Practice Address - Phone:423-762-5263
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental