Provider Demographics
NPI:1184732661
Name:HARIA, AVISH ANIL (DDS)
Entity type:Individual
Prefix:DR
First Name:AVISH
Middle Name:ANIL
Last Name:HARIA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7517 CAMERON RD STE 107
Mailing Address - Street 2:CARUS DENTAL
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-2055
Mailing Address - Country:US
Mailing Address - Phone:512-371-1222
Mailing Address - Fax:512-371-3914
Practice Address - Street 1:16000 PARK VALLEY DR STE 100
Practice Address - Street 2:CARUS DENTAL
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4009
Practice Address - Country:US
Practice Address - Phone:512-244-7995
Practice Address - Fax:512-310-0451
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX21059122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist