Provider Demographics
NPI:1215159611
Name:HARRINGTON, MARK J (DDS)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2150 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2206
Mailing Address - Country:US
Mailing Address - Phone:763-421-9292
Mailing Address - Fax:763-421-7559
Practice Address - Street 1:2150 3RD AVE
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2206
Practice Address - Country:US
Practice Address - Phone:763-421-9292
Practice Address - Fax:763-421-7559
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN100831223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics