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General NPI Number Information
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NPI Number | 1770666562
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Entity Type | Individual
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Provider Name | CHARLES R HARRIS JR. D.D.S.F.A.G.D.
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Gender | Male
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2922 GEORGE WASHINGTON HIGHWAY
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City | HAYES
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State | VA
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Zip | 23072
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Country | US
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Telephone | 804-642-4893
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Fax | 804-642-5995
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Provider Business Mailing Address
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Address Line | PO BOX 375
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City | HAYES
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State | VA
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Zip | 23072-0375
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Country | US
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Telephone | 804-642-4893
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Fax | 804-642-5995
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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 | 3618
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License Number State | VA
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