MEDICARE: RICK K. HARRISON, D.M.D., PA

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1881457083
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICK K. HARRISON, D.M.D., PA

Provider Business Mailing Address
First Line	:	227 11TH AVE S
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-6529
Country	:	US
Telephone Number	:	904-241-4237
Fax Number	:

Provider Business Practice Location Address
First Line	:	227 11TH AVE S
Second Line	:
City	:	JACKSONVILLE BEACH
State	:	FL
Zip	:	32250-6529
Country	:	US
Telephone Number	:	904-241-4237
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RICK KENNETH HARRISON
Credential	:	DMD
Telephone Number	:	904-241-4237

Provider Enumeration Date	:	02/01/2024
Last Update Date	:	02/01/2024

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