Healthcare Provider Details

I. General information

NPI: 1558043042
Provider Name (Legal Business Name): LANCE HARRIS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20307 VIKING AVE NW STE 101
POULSBO WA
98370-8321
US

IV. Provider business mailing address

20307 VIKING AVE NW STE 101
POULSBO WA
98370-8321
US

V. Phone/Fax

Practice location:
  • Phone: 760-213-2739
  • Fax:
Mailing address:
  • Phone: 760-213-2739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: LANCE RICHARD HARRIS
Title or Position: GENERAL DENTIST/OWNER
Credential: DMD
Phone: 760-213-2739