Provider Demographics
NPI:1861198251
Name:HARRIS, SAMUEL L (DDS)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:L
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 1:3000 N HILLS BLVD APT 15465
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-9426
Mailing Address - Country:US
Mailing Address - Phone:256-682-1647
Mailing Address - Fax:
Practice Address - Street 1:2000 S UNIVERSITY AVE STE K
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-3603
Practice Address - Country:US
Practice Address - Phone:501-270-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-07
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401418288122300000X
CA11045441223X0400X
AR48291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No122300000XDental ProvidersDentist