MEDICARE: DR. HARRY ALLEN HART DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	30554	CA

General Provider Information

NPI Number	:	1598812802
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRY ALLEN HART DDS

Provider Business Mailing Address
First Line	:	2363 TRAFALGAR AVE
Second Line	:
City	:	RIVERSIDE
State	:	CA
Zip	:	92506-4627
Country	:	US
Telephone Number	:	951-377-7455
Fax Number	:

Provider Business Practice Location Address
First Line	:	11999 PALM DR
Second Line	:
City	:	DESERT HOT SPRINGS
State	:	CA
Zip	:	92240-3609
Country	:	US
Telephone Number	:	760-329-6713
Fax Number	:	760-329-1088

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

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