Healthcare Provider Details

I. General information

NPI: 1962570630
Provider Name (Legal Business Name): BRIEN V. HARVEY, DDS, MS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

899 N WILMOT RD STE E2
TUCSON AZ
85711-1713
US

IV. Provider business mailing address

899 N WILMOT RD STE E2
TUCSON AZ
85711-1713
US

V. Phone/Fax

Practice location:
  • Phone: 520-745-5722
  • Fax: 520-745-2991
Mailing address:
  • Phone: 520-745-5722
  • Fax: 520-745-2991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number3624
License Number StateAZ

VIII. Authorized Official

Name: DR. BRIEN VOORHEES HARVEY
Title or Position: OWNER
Credential: D.D.S., M.S.
Phone: 520-745-5722