Provider Demographics
NPI:1952468845
Name:HARRIS, ROBERT CLINTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLINTON
Last Name:HARRIS
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 1:280 W CATALINA DR
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-8272
Mailing Address - Country:US
Mailing Address - Phone:928-783-3104
Mailing Address - Fax:
Practice Address - Street 1:280 W CATALINA DR
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8272
Practice Address - Country:US
Practice Address - Phone:928-343-2110
Practice Address - Fax:928-343-0078
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ48901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice