Provider Demographics
NPI:1548316375
Name:MAX E. HARKEY, D.M.D., P.C.
Entity type:Organization
Organization Name:MAX E. HARKEY, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:E
Authorized Official - Last Name:HARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-924-3262
Mailing Address - Street 1:PO BOX 585
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65704-0585
Mailing Address - Country:US
Mailing Address - Phone:417-924-3262
Mailing Address - Fax:
Practice Address - Street 1:104 S. LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MO
Practice Address - Zip Code:65704
Practice Address - Country:US
Practice Address - Phone:417-924-3262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0144131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty