Provider Demographics
NPI:1982147989
Name:HARMON, MARC (DDS)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:
Last Name:HARMON
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 1:32 MAIN ST # 171
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-2927
Mailing Address - Country:US
Mailing Address - Phone:802-659-4865
Mailing Address - Fax:
Practice Address - Street 1:32 MAIN ST # 171
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-2927
Practice Address - Country:US
Practice Address - Phone:802-659-4865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT016-00020861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice