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General NPI Number Information
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NPI Number | 1497927982
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Entity Type | Organization
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Legal Business Name | MARVIN DARRELL HARMAN, DDS, PC
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Dates
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Enumeration Date | 03/25/2008
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Last Update Date | 03/25/2008
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Provider Practice Location Address
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Address Line | 107 TAZEWELL AVE
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City | RICHLANDS
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State | VA
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Zip | 24641-2250
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Country | US
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Telephone | 276-964-7418
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Fax | 276-964-6465
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Provider Business Mailing Address
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Address Line | PO BOX 700
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City | RICHLANDS
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State | VA
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Zip | 24641-0700
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Country | US
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Telephone | 276-964-7418
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Fax | 276-964-6465
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARVIN DARRELL HARMAN
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Credential | DDS
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Telephone | 276-964-7418
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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 | 0401004098
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License Number State | VA
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