Provider Demographics
NPI:1245645712
Name:HARRIS, SETH ADAM (DDS)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:ADAM
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 1:308 MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-5715
Mailing Address - Country:US
Mailing Address - Phone:830-798-0844
Mailing Address - Fax:
Practice Address - Street 1:308 MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-5715
Practice Address - Country:US
Practice Address - Phone:830-798-0844
Practice Address - Fax:830-798-0744
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30121122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist