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General NPI Number Information
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NPI Number | 1811187883
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Entity Type | Organization
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Legal Business Name | HARVEY DENTISTRY SML PC
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Dates
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Enumeration Date | 07/26/2007
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Last Update Date | 07/26/2007
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Provider Practice Location Address
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Address Line | 13245 BOOKER T WASHINGTON HWY STE D
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City | HARDY
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State | VA
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Zip | 24101-3947
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Country | US
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Telephone | 540-721-2448
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Fax | 540-721-3215
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Provider Business Mailing Address
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Address Line | 13245 BOOKER T WASHINGTON HWY STE D
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City | HARDY
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State | VA
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Zip | 24101-3947
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Country | US
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Telephone | 540-721-2448
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Fax | 540-721-3215
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. GREGORY TODD HARVEY
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Credential | D.M.D.
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Telephone | 540-721-2448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0401410880
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License Number State | VA
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