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General NPI Number Information
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NPI Number | 1790901783
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Entity Type | Organization
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Legal Business Name | JEFFREY A. HARRISON, D.M.D.,P.C.
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 258 WASHINGTON ST
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City | WELLESLEY
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State | MA
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Zip | 02481-4964
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Country | US
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Telephone | 781-237-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 27 ROBERT FROST RD
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City | SUDBURY
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State | MA
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Zip | 01776-3423
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Country | US
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Telephone | 978-443-4323
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Fax |
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Authorized Official
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Title or Position | C.E.O.
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Name | DR. JEFFREY A. HARRISON
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Credential | D.M.D.
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Telephone | 781-237-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 16476MA
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License Number State | MA
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