Provider Demographics
NPI:1447374442
Name:HARRIS, STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
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 1:150 MONTAGUE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3514
Mailing Address - Country:US
Mailing Address - Phone:718-522-4445
Mailing Address - Fax:718-522-5342
Practice Address - Street 1:150 MONTAGUE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3514
Practice Address - Country:US
Practice Address - Phone:718-522-4445
Practice Address - Fax:718-522-5342
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0420491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice