Provider Demographics
NPI:1134338635
Name:HARRIS, JOSEPH CARTER (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CARTER
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 1:2431 W GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48208-1210
Mailing Address - Country:US
Mailing Address - Phone:313-895-4300
Mailing Address - Fax:313-895-2994
Practice Address - Street 1:2431 W GRAND BLVD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48208-1210
Practice Address - Country:US
Practice Address - Phone:313-895-4300
Practice Address - Fax:313-895-2994
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI0148921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice