MEDICARE: DR. MATTHEW R HARMON D.D.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	1223G0001X	General Practice Dentistry	60389	KS

General Provider Information

NPI Number	:	1992749378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW R HARMON D.D.S.

Provider Business Mailing Address
First Line	:	840 LAKIN STREET
Second Line	:
City	:	OSAGE CITY
State	:	KS
Zip	:	66523-1152
Country	:	US
Telephone Number	:	785-528-3773
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 LAKIN STREET
Second Line	:
City	:	OSAGE CITY
State	:	KS
Zip	:	66523-1152
Country	:	US
Telephone Number	:	785-528-3773
Fax Number	:

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	09/11/2012

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