Provider Demographics
NPI:1801978408
Name:VREDEVELD, HARMON KENNETH (DDS)
Entity type:Individual
Prefix:DR
First Name:HARMON
Middle Name:KENNETH
Last Name:VREDEVELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6140 PARKLAND BLVD
Mailing Address - Street 2:SUITE 100 AMERICAN DENTAL CENTERS
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124
Mailing Address - Country:US
Mailing Address - Phone:440-446-1555
Mailing Address - Fax:440-446-1990
Practice Address - Street 1:2086 EAST DUBLIN GRANVILLE RD
Practice Address - Street 2:AMERICAN DENTAL CENTERS
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229
Practice Address - Country:US
Practice Address - Phone:614-901-0939
Practice Address - Fax:614-901-2890
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH30219421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice