Provider Demographics
NPI:1043501885
Name:HARMON, SHAWNA LYNNE (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAWNA
Middle Name:LYNNE
Last Name:HARMON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 BILTON RD
Mailing Address - Street 2:POB 100
Mailing Address - City:SOMERS
Mailing Address - State:CT
Mailing Address - Zip Code:06071-1044
Mailing Address - Country:US
Mailing Address - Phone:860-814-4600
Mailing Address - Fax:860-814-4826
Practice Address - Street 1:335 BILTON RD
Practice Address - Street 2:POB 100
Practice Address - City:SOMERS
Practice Address - State:CT
Practice Address - Zip Code:06071-1044
Practice Address - Country:US
Practice Address - Phone:860-814-4600
Practice Address - Fax:860-814-4826
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010120122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist