MEDICARE: DR. HARRISON FILLER DMD

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	122300000X	Dentist	6517	AL

General Provider Information

NPI Number	:	1760976179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRISON FILLER DMD

Provider Business Mailing Address
First Line	:	1940 MOUNTAIN LAUREL LN
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35244-1113
Country	:	US
Telephone Number	:	205-767-7651
Fax Number	:

Provider Business Practice Location Address
First Line	:	5751 POCAHONTAS RD
Second Line	:
City	:	BESSEMER
State	:	AL
Zip	:	35022-5476
Country	:	US
Telephone Number	:	205-477-4242
Fax Number	:

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

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	06/19/2018

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Directions to “ DR. HARRISON FILLER DMD” Practice Location

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