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General NPI Number Information
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NPI Number | 1194942268
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Entity Type | Organization
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Legal Business Name | LEE B. HARRISON, D.D.S., P.C.
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 04/01/2009
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Provider Practice Location Address
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Address Line | 1620 HILLCREST DR
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City | VERNON
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State | TX
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Zip | 76384-4053
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Country | US
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Telephone | 406-279-3543
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Fax | 406-279-3543
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Provider Business Mailing Address
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Address Line | PO BOX 185
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City | VALIER
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State | MT
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Zip | 59486-0185
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Country | US
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Telephone | 406-279-3543
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Fax | 406-279-3543
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LEE BONDURANT HARRISON
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Credential | D.D.S.
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Telephone | 406-279-3543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10409
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License Number State | TX
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