Provider Demographics
NPI:1164642559
Name:HARSANT, DAVID JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:HARSANT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 YADKIN ROAD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28303-2167
Mailing Address - Country:US
Mailing Address - Phone:910-864-4646
Mailing Address - Fax:910-864-6271
Practice Address - Street 1:6402 YADKIN ROAD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-2167
Practice Address - Country:US
Practice Address - Phone:910-864-4646
Practice Address - Fax:910-864-6271
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC47741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice