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General NPI Number Information
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NPI Number | 1962377606
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Entity Type | Individual
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Provider Name | KRISTIN DAWN HARRIS
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Gender | Female
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Dates
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Enumeration Date | 10/10/2025
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 2232 GRAND AVE
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City | FORT MYERS
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State | FL
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Zip | 33901-3717
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Country | US
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Telephone | 239-344-2341
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Fax | 239-334-7518
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Provider Business Mailing Address
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Address Line | 16161 PENNYROYAL LN
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City | PUNTA GORDA
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State | FL
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Zip | 33982-6040
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Country | US
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Telephone | 239-699-4825
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Fax | 239-699-4825
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | DH19803
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License Number State | FL
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