| Harrison Dental | |
|
225 S Harrison St Shelbyville IN 46176-2159 | |
| (317) 398-0066 | |
| Not Available |
| Full Name | Harrison Dental |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 225 S Harrison St, Shelbyville, Indiana |
| Authorized Official Name and Position | Jean Tungate (OFFICE MANAGER) |
| Authorized Official Contact | 3173980066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harrison Dental 225 S Harrison St Shelbyville IN 46176-2159 Ph: (317) 398-0066 | Harrison Dental 225 S Harrison St Shelbyville IN 46176-2159 Ph: (317) 398-0066 |
| NPI Number | 1023432200 |
|---|---|
| Provider Enumeration Date | 02/10/2014 |
| Last Update Date | 02/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023432200 | NPI | - | NPPES |
| 12011411A | Other | IN | DENTAL LICENSE |
| 1487775144 | Other | IN | NPI TYPE 1 |
| 1376687509 | Other | IN | NPI TYPE 1 |
| 12009085A | Other | IN | DENTAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12009085A (Indiana) | Secondary |
| 1223P0300X | Dentist - Periodontics | 12011411A (Indiana) | Primary |
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