Provider Demographics
NPI:1659422277
Name:HARRIS, JAMES JOSEPH (DMD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:JOSEPH
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:428 HORIZON TRL
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-5041
Mailing Address - Country:US
Mailing Address - Phone:404-825-8751
Mailing Address - Fax:
Practice Address - Street 1:2035 TOWNE LAKE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-5550
Practice Address - Country:US
Practice Address - Phone:770-926-8200
Practice Address - Fax:770-951-9387
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0093471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice