Healthcare Provider Details

I. General information

NPI: 1942391362
Provider Name (Legal Business Name): FRANK W HARMON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 BERT KOUNS SUITE D
SHREVEPORT LA
71118
US

IV. Provider business mailing address

2120 BERT KOUNS SUITE D
SHREVEPORT LA
71118
US

V. Phone/Fax

Practice location:
  • Phone: 318-687-9800
  • Fax: 318-687-4752
Mailing address:
  • Phone: 318-687-9800
  • Fax: 318-687-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number4245
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: