Provider Demographics
NPI:1336756865
Name:CHESSER, HARRY WAYNE JR (DDS)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:WAYNE
Last Name:CHESSER
Suffix:JR
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 1:7575 N OUTLOOK LN
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86315-4591
Mailing Address - Country:US
Mailing Address - Phone:970-852-0055
Mailing Address - Fax:
Practice Address - Street 1:222 S SUMMIT AVE STE 2
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-3780
Practice Address - Country:US
Practice Address - Phone:970-852-0055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-29
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0108801223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice