Provider Demographics
NPI:1265605323
Name:HARRIS, ANA MARIA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANA
Middle Name:MARIA
Last Name:HARRIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ANA
Other - Middle Name:MARIA
Other - Last Name:GALARZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:13889 WELLINGTON TRCE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-2121
Mailing Address - Country:US
Mailing Address - Phone:561-258-9976
Mailing Address - Fax:
Practice Address - Street 1:13889 WELLINGTON TRCE
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-2121
Practice Address - Country:US
Practice Address - Phone:561-258-9976
Practice Address - Fax:561-637-4428
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 176201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice