Provider Demographics
NPI:1356787121
Name:PAUL W. HARR, D.D.S., INC.
Entity type:Organization
Organization Name:PAUL W. HARR, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:VANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-399-5211
Mailing Address - Street 1:721 TOM TIM DR
Mailing Address - Street 2:
Mailing Address - City:PAULDING
Mailing Address - State:OH
Mailing Address - Zip Code:45879-9245
Mailing Address - Country:US
Mailing Address - Phone:419-399-5211
Mailing Address - Fax:419-399-5545
Practice Address - Street 1:721 TOM TIM DR
Practice Address - Street 2:
Practice Address - City:PAULDING
Practice Address - State:OH
Practice Address - Zip Code:45879-9245
Practice Address - Country:US
Practice Address - Phone:419-399-5211
Practice Address - Fax:419-399-5545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-20
Last Update Date:2013-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30. 01490261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0207298Medicaid