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General NPI Number Information
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NPI Number | 1467822924
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Entity Type | Organization
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Legal Business Name | HARRIS DENTAL GROUP PLLC
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Dates
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Enumeration Date | 09/28/2015
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Last Update Date | 06/18/2019
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Provider Practice Location Address
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Address Line | 421 N 38TH ST
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City | KILLEEN
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State | TX
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Zip | 76543-4153
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Country | US
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Telephone | 254-634-0234
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Fax |
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Provider Business Mailing Address
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Address Line | 421 N 38TH ST
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City | KILLEEN
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State | TX
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Zip | 76543-4153
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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 | OWNER/DENTIST
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Name | MICHAEL EUGENE HARRIS
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Credential | DDS
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Telephone | 254-634-0234
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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 |
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License Number State |
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