Provider Demographics
NPI:1861688426
Name:HARRIS, ALLISON COVINGTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:COVINGTON
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 MCGREGOR RD
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-8644
Mailing Address - Country:US
Mailing Address - Phone:386-736-9966
Mailing Address - Fax:386-822-9959
Practice Address - Street 1:154 MCGREGOR RD
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-8644
Practice Address - Country:US
Practice Address - Phone:386-736-9966
Practice Address - Fax:386-822-9959
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 18050122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist