Provider Demographics
NPI:1659490282
Name:DAVID J HARSANT DDS PA
Entity Type:Organization
Organization Name:DAVID J HARSANT DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAAVID
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:HARSANT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:910-864-4646
Mailing Address - Street 1:6402 YADKIN RD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-2167
Mailing Address - Country:US
Mailing Address - Phone:910-864-4646
Mailing Address - Fax:910-864-6271
Practice Address - Street 1:6402 YADKIN RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-2167
Practice Address - Country:US
Practice Address - Phone:910-864-4646
Practice Address - Fax:910-864-6271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty