Provider Demographics
NPI:1710999420
Name:HARMAN, AARON (DDS)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:
Last Name:HARMAN
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 1:302 S HAYES AVE
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-5551
Mailing Address - Country:US
Mailing Address - Phone:918-485-3371
Mailing Address - Fax:918-485-9175
Practice Address - Street 1:302 S HAYES AVE
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-5551
Practice Address - Country:US
Practice Address - Phone:918-485-3371
Practice Address - Fax:918-485-9175
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK56051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2000001150AMedicaid