Provider Demographics
NPI:1811980576
Name:HARRIS, DANIEL BRIAN (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:BRIAN
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 GALLERIA DR STE 202
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-2196
Mailing Address - Country:US
Mailing Address - Phone:504-456-5033
Mailing Address - Fax:504-456-5057
Practice Address - Street 1:3100 GALLERIA DR STE 202
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-2196
Practice Address - Country:US
Practice Address - Phone:504-456-5033
Practice Address - Fax:504-456-5057
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5570122300000X, 204E00000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery