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NPI Code Detail

MEDICARE: DR. LANCE HERSCHEL HARRISON JR. DDS

MEDICARE:  DR. LANCE HERSCHEL HARRISON JR. 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
1122300000XDentist053622NY
2122300000XDentist8737TN
3122300000XDentistDN27515FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598944340
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LANCE HERSCHEL HARRISON JR. DDS
Provider Business Mailing Address
First Line : 813 PARK DR
Second Line :
City : GOODLETTSVILLE
State : TN
Zip : 37072-3147
Country : US
Telephone Number : 561-388-5819
Fax Number :
Provider Business Practice Location Address
First Line : 7725 LAKE WORTH RD STE 7729
Second Line :
City : LAKE WORTH
State : FL
Zip : 33467-2536
Country : US
Telephone Number : 561-359-6483
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/29/2007
Last Update Date : 03/10/2023

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Directions to “ DR. LANCE HERSCHEL HARRISON JR. DDS” Practice Location

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