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General NPI Number Information
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NPI Number | 1073953840
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Entity Type | Individual
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Provider Name | JOHN HARRISON D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/26/2013
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 2879 WILLOW PASS RD
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City | CONCORD
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State | CA
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Zip | 94519-2553
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Country | US
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Telephone | 925-685-0519
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Fax |
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Provider Business Mailing Address
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Address Line | 2004A WHITE AVE
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City | NASHVILLE
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State | TN
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Zip | 37204-2242
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 10058
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 109076
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License Number State | CA
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