Provider Demographics
NPI:1851669303
Name:HARR, MELINDA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:A
Last Name:HARR
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1509 32ND AVE S
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5990
Mailing Address - Country:US
Mailing Address - Phone:701-271-1060
Mailing Address - Fax:701-271-1164
Practice Address - Street 1:1509 32ND AVE S
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5990
Practice Address - Country:US
Practice Address - Phone:701-271-1060
Practice Address - Fax:701-271-1164
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND1905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist