Provider Demographics
NPI:1659302727
Name:HARROUFF, WADE BYRON (DDS)
Entity Type:Individual
Prefix:DR
First Name:WADE
Middle Name:BYRON
Last Name:HARROUFF
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 1:1000 N US HIGHWAY 1 APT 615
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-4301
Mailing Address - Country:US
Mailing Address - Phone:561-262-3548
Mailing Address - Fax:
Practice Address - Street 1:6390 W INDIANTOWN RD STE 32
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33458-7980
Practice Address - Country:US
Practice Address - Phone:561-741-7142
Practice Address - Fax:561-741-7914
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN10761122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN10761OtherLICENSE #