Provider Demographics
NPI:1740445360
Name:HARRIS, SCOTT J (DMD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:J
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 N MILITARY TRL
Mailing Address - Street 2:SUITE 250
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-1814
Mailing Address - Country:US
Mailing Address - Phone:561-910-6999
Mailing Address - Fax:561-910-7244
Practice Address - Street 1:3020 N MILITARY TRL
Practice Address - Street 2:SUITE 250
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-1814
Practice Address - Country:US
Practice Address - Phone:561-910-6999
Practice Address - Fax:561-910-7244
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18453122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist