Healthcare Provider Details

I. General information

NPI: 1346639317
Provider Name (Legal Business Name): DOUGLAS J. HARRINGTON,D.D.S.,A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2015
Last Update Date: 02/01/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 NIBLICK RD
PASO ROBLES CA
93446-4842
US

IV. Provider business mailing address

118 NIBLICK RD
PASO ROBLES CA
93446-4842
US

V. Phone/Fax

Practice location:
  • Phone: 805-226-8508
  • Fax: 805-226-8576
Mailing address:
  • Phone: 805-226-8508
  • Fax: 805-226-8576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number43533
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number43533
License Number StateCA

VIII. Authorized Official

Name: DR. DOUGLAS HARRINGTON
Title or Position: OWNER/OPERATOR
Credential: D.D.S.
Phone: 805-226-8508