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General NPI Number Information
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NPI Number | 1114362258
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Entity Type | Individual
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Provider Name | NICHOLAS RAY HARKER D.D.S
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Gender | Male
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Dates
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Enumeration Date | 05/02/2013
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 915 E HAWTHORNE RD STE G
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City | SPOKANE
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State | WA
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Zip | 99218-1482
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Country | US
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Telephone | 509-302-1321
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Fax |
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Provider Business Mailing Address
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Address Line | 915 E HAWTHORNE RD STE G
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City | SPOKANE
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State | WA
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Zip | 99218-1482
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Country | US
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Telephone | 509-464-4100
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DE60361349
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D-4527
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License Number State | ID
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