NPI 1780203174

Mark Lee Harris, DDS

Practitioner Dentist Tyndall Afb, FL

Practice location

Address: 340 Magnolia Cir, Tyndall Afb, FL 32403-5604
Phone: (502) 837-4448
Mailing address: 340 Magnolia Cir # 5612, Tyndall Afb, FL 32403-5612

Registered specialties (2)

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 0401417042 (VA)

Other Dentist providers in Florida →

Dentist

Dental Providers Taxonomy 122300000X Licence STUDENT (MD)

Registry record

NPI: 1780203174
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Apr 2020
Record last updated: 23 Sep 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.