MEDICARE: JOHN R HARPER 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	122300000X	Dentist	2901012170	MI

General Provider Information

NPI Number	:	1497761639
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN R HARPER DDS

Provider Business Mailing Address
First Line	:	17200 MACK AVE
Second Line	:
City	:	GROSSE POINTE CITY
State	:	MI
Zip	:	48230-6253
Country	:	US
Telephone Number	:	313-882-4891
Fax Number	:	313-882-0701

Provider Business Practice Location Address
First Line	:	17200 MACK AVE
Second Line	:
City	:	GROSSE POINTE CITY
State	:	MI
Zip	:	48230-6253
Country	:	US
Telephone Number	:	313-882-4891
Fax Number	:	313-882-0701

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

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	07/08/2007

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