Provider Demographics
NPI:1801817770
Name:TEMPLE, HARRY V (DMD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:V
Last Name:TEMPLE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 HARVARD ST
Mailing Address - Street 2:SUITE 502
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5071
Mailing Address - Country:US
Mailing Address - Phone:617-731-1200
Mailing Address - Fax:617-731-1215
Practice Address - Street 1:209 HARVARD ST
Practice Address - Street 2:SUITE 502
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02446-5071
Practice Address - Country:US
Practice Address - Phone:617-731-1200
Practice Address - Fax:617-731-1215
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA133451223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX05135OtherBLUE CROSS BLUE SHIELD MA