Robert Dover Harris, D.D.S.

Individual provider Active NPI General Practice Dentistry · Broadway, VA

NPI 1619255247 · NPPES record last updated Apr 27, 2016

Key facts

NPI
1619255247
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
0401413222 (VA)
Practice address
111A S Timberway
Broadway, VA 22815-9739
Phone
(540) 901-2151
NPI assigned
Aug 1, 2011
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0401413222VAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401413222 VA Yes

Addresses

Primary practice location

111A S Timberway
Broadway, VA 22815-9739

Mailing address

111A S Timberway
Broadway, VA 22815-9739
Phone (540) 901-2151

Other providers in Broadway, VA

All providers in Broadway, VA · General Practice Dentistry in Virginia

Sources for this page

Verify at the official NPI Registry.