Provider Demographics
NPI:1841384872
Name:DEGIROLAMO, HARRY J (DMD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:J
Last Name:DEGIROLAMO
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 1:238 LIVE OAK DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94506-2151
Mailing Address - Country:US
Mailing Address - Phone:925-736-1332
Mailing Address - Fax:925-736-4170
Practice Address - Street 1:238 LIVE OAK DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94506-2151
Practice Address - Country:US
Practice Address - Phone:925-736-1332
Practice Address - Fax:925-736-4170
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD217021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice