Provider Demographics
NPI:1255334645
Name:HARMS, GREGORY ALLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALLAN
Last Name:HARMS
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 1:8900 PENN AVE S
Mailing Address - Street 2:STE 201
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55431-2068
Mailing Address - Country:US
Mailing Address - Phone:952-884-5242
Mailing Address - Fax:952-884-0845
Practice Address - Street 1:8900 PENN AVE S
Practice Address - Street 2:STE 201
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55431-2068
Practice Address - Country:US
Practice Address - Phone:952-884-5242
Practice Address - Fax:952-884-0845
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist