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General NPI Number Information
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NPI Number | 1144438276
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Entity Type | Organization
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Legal Business Name | MICHAEL E HARRIS DDS PSC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 218 W JOHN FITCH
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City | BANDSTOWN
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State | KY
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Zip | 40004
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Country | US
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Telephone | 502-348-9775
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Fax | 502-348-2756
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Provider Business Mailing Address
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Address Line | 218 W JOHN FITCH
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City | BANDSTOWN
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State | KY
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Zip | 40004
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Country | US
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Telephone | 502-348-9775
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Fax | 502-348-2756
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL EARL HARRIS
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Credential | DDS
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Telephone | 502-348-9775
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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 | 4122
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License Number State | KY
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