MEDICARE: DR. LECIA ERIN HARMER D.D.S., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	56905	CA

General Provider Information

NPI Number	:	1003089434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LECIA ERIN HARMER D.D.S., M.S.

Provider Business Mailing Address
First Line	:	16542 VENTURA BLVD
Second Line	:	SUITE 506
City	:	ENCINO
State	:	CA
Zip	:	91436
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6345 BALBOA BLVD STE 314
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91316-1500
Country	:	US
Telephone Number	:	818-943-8228
Fax Number	:	509-271-7372

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2008
Last Update Date	:	09/26/2017

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