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General NPI Number Information
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NPI Number | 1891427670
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Entity Type | Individual
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Provider Name | JENNA RUTH HARRIS DMD
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 5400 BARBER MILL RD
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City | CLAYTON
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State | NC
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Zip | 27520-7260
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Country | US
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Telephone | 919-553-2238
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Fax |
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Provider Business Mailing Address
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Address Line | 207 CHERRY LAUREL DR
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City | CLAYTON
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State | NC
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Zip | 27527-6640
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Country | US
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Telephone | 919-634-7809
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 12821
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License Number State | NC
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