Provider Demographics
NPI:1144433046
Name:HARRIS, DAVID JAMES JR (DDS, MSD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:HARRIS
Suffix:JR
Gender:M
Credentials:DDS, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3869 DARROW RD STE 209
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2677
Mailing Address - Country:US
Mailing Address - Phone:330-688-3800
Mailing Address - Fax:330-688-3100
Practice Address - Street 1:3869 DARROW RD STE 209
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2677
Practice Address - Country:US
Practice Address - Phone:330-688-3800
Practice Address - Fax:330-688-3100
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-98731223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics