Provider Demographics
NPI:1538235700
Name:HARRIS, HERBERT AARON (DDS)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:AARON
Last Name:HARRIS
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 1:1005 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE CITY
Mailing Address - State:IN
Mailing Address - Zip Code:47327-1440
Mailing Address - Country:US
Mailing Address - Phone:765-478-4344
Mailing Address - Fax:765-478-4473
Practice Address - Street 1:1005 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE CITY
Practice Address - State:IN
Practice Address - Zip Code:47327-1440
Practice Address - Country:US
Practice Address - Phone:765-478-4344
Practice Address - Fax:765-478-4473
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12009565122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist