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General NPI Number Information
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NPI Number | 1861524928
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Entity Type | Organization
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Legal Business Name | DR MITCHELL R HARPER
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Dates
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Enumeration Date | 03/12/2007
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 5422 EUPER LANE
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City | FORT SMITH
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State | AR
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Zip | 72903
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Country | US
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Telephone | 479-452-1638
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Fax | 479-452-1639
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Provider Business Mailing Address
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Address Line | 5422 EUPER LANE
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City | FORT SMITH
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State | AR
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Zip | 72903
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Country | US
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Telephone | 479-452-1638
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Fax | 479-452-1639
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Authorized Official
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Title or Position | DENTIST
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Name | MITCHELL RAYMOND HARPER
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Credential | D.D.S.
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Telephone | 479-452-1638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2612
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License Number State | AR
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