MEDICARE: DR. DENNIS LEW HARPER 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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS00984	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	016053	OTHER	MO	DENTAL SPECIALIST LICENSE

General Provider Information

NPI Number	:	1588606248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENNIS LEW HARPER D.D.S., M.S.

Provider Business Mailing Address
First Line	:	16A WESTWOODS DR
Second Line	:
City	:	LIBERTY
State	:	MO
Zip	:	64068-3519
Country	:	US
Telephone Number	:	816-781-9230
Fax Number	:	816-781-9670

Provider Business Practice Location Address
First Line	:	16A WESTWOODS DR
Second Line	:
City	:	LIBERTY
State	:	MO
Zip	:	64068-3519
Country	:	US
Telephone Number	:	816-781-9230
Fax Number	:	816-781-9670

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

Provider Enumeration Date	:	06/10/2006
Last Update Date	:	07/08/2007

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