John Andrew Harris, DMD

Individual provider Active NPI General Practice Dentistry · Montgomery, AL

NPI 1740397553 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1740397553
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
2759 (AL)
Practice address
Cavhcs 215 Perry Hill Road
Montgomery, AL 26109
Phone
(334) 272-4670
Fax
(334) 260-4191
NPI assigned
Aug 25, 2006
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
2759ALMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2759 AL Yes

Addresses

Primary practice location

Cavhcs 215 Perry Hill Road
Montgomery, AL 26109

Mailing address

530 Farmington Rd
Montgomery, AL 36109-4610

Other providers in Montgomery, AL

All providers in Montgomery, AL · General Practice Dentistry in Alabama

Sources for this page

Verify at the official NPI Registry.