MEDICARE: DR. HARRIS GURFINKEL DDS

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	1223G0001X	General Practice Dentistry	17192	MI

General Provider Information

NPI Number	:	1255499182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRIS GURFINKEL DDS

Provider Business Mailing Address
First Line	:	4819 HAGGERTY RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-3901
Country	:	US
Telephone Number	:	248-624-0200
Fax Number	:	248-624-0201

Provider Business Practice Location Address
First Line	:	4819 HAGGERTY RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48323-3901
Country	:	US
Telephone Number	:	248-624-0200
Fax Number	:	248-624-0201

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

Provider Enumeration Date	:	12/04/2006
Last Update Date	:	07/08/2007

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