Provider Demographics
NPI:1740606045
Name:MICHAEL R HARPER DDS PA
Entity type:Organization
Organization Name:MICHAEL R HARPER DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:941-629-3200
Mailing Address - Street 1:21202 OLEAN BLVD
Mailing Address - Street 2:STE E2
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952-6751
Mailing Address - Country:US
Mailing Address - Phone:941-629-3200
Mailing Address - Fax:941-629-2113
Practice Address - Street 1:21202 OLEAN BLVD
Practice Address - Street 2:STE E2
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-6751
Practice Address - Country:US
Practice Address - Phone:941-629-3200
Practice Address - Fax:941-629-2113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-11
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty