Provider Demographics
NPI:1699814673
Name:JAY J HARRIS DMD PC
Entity Type:Organization
Organization Name:JAY J HARRIS DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JAY
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:302-453-1400
Mailing Address - Street 1:220 CHRISTIANA MEDICAL CTR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-1652
Mailing Address - Country:US
Mailing Address - Phone:302-453-1400
Mailing Address - Fax:302-453-9553
Practice Address - Street 1:220 CHRISTIANA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-1652
Practice Address - Country:US
Practice Address - Phone:302-453-1400
Practice Address - Fax:302-453-9553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEGI 0001169122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty