MEDICARE: ROBERT B. HARRISON DMD MSD PLLC

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	4047	NC
2	261QM1300X	Multi-Specialty Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	423243	OTHER	NC	UNITED CONCORDIA
2	91755	OTHER	NC	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396906780
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT B. HARRISON DMD MSD PLLC

Provider Business Mailing Address
First Line	:	700 MCCARTHY BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5233
Country	:	US
Telephone Number	:	252-633-0424
Fax Number	:	252-638-6662

Provider Business Practice Location Address
First Line	:	700 MCCARTHY BLVD
Second Line	:
City	:	NEW BERN
State	:	NC
Zip	:	28562-5233
Country	:	US
Telephone Number	:	252-633-0424
Fax Number	:	252-638-6662

Authorized Official
Title or Position	:	OWNER
Name	:	ROBERT BRYAN HARRISON
Credential	:	DMD. MSD
Telephone Number	:	252-633-0424

Provider Enumeration Date	:	06/19/2008
Last Update Date	:	05/03/2024

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