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NPI Code Detail

MEDICARE: MICHAEL JAMES HARRISON DDS

MEDICARE: MICHAEL JAMES HARRISON 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
11223G0001XGeneral Practice DentistryD10529MN

General Provider Information

NPI Number : 1679872972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JAMES HARRISON DDS
Provider Business Mailing Address
First Line : 6600 FRANCE AVE S
Second Line : SUITE 415
City : EDINA
State : MN
Zip : 55435-1805
Country : US
Telephone Number : 952-224-9771
Fax Number : 952-224-9790
Provider Business Practice Location Address
First Line : 1340 DUCKWOOD DR
Second Line :
City : EAGAN
State : MN
Zip : 55123-2324
Country : US
Telephone Number : 651-209-9999
Fax Number : 651-209-0396
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2011
Last Update Date : 03/25/2011

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Directions to “ MICHAEL JAMES HARRISON DDS” Practice Location

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