Provider Demographics
NPI:1316063431
Name:HARRIS, HEATHER KATHLEEN (DDS)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:KATHLEEN
Last Name:HARRIS
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 1:201 UNIVERSITY BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-4657
Mailing Address - Country:US
Mailing Address - Phone:303-393-0039
Mailing Address - Fax:303-393-0928
Practice Address - Street 1:201 UNIVERSITY BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4657
Practice Address - Country:US
Practice Address - Phone:303-393-0039
Practice Address - Fax:303-393-0928
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO79001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice