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General NPI Number Information
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NPI Number | 1225117989
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Entity Type | Individual
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Provider Name | KIM HARRIS D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 11/03/2006
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Last Update Date | 03/17/2015
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Provider Practice Location Address
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Address Line | 6225 W 56TH ST SUITE 100
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City | INDIANAPOLIS
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State | IN
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Zip | 46254-7603
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Country | US
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Telephone | 317-293-3300
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Fax | 317-293-3437
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Provider Business Mailing Address
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Address Line | 7755 WALKER CUP DR
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City | BROWNSBURG
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State | IN
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Zip | 46112-9183
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12009550
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License Number State | IN
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