Provider Demographics
NPI:1588958060
Name:GOHN, HARRY EDWARD III (DMD)
Entity type:Individual
Prefix:DR
First Name:HARRY
Middle Name:EDWARD
Last Name:GOHN
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 LOG POND DR
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-1905
Mailing Address - Country:US
Mailing Address - Phone:267-240-1312
Mailing Address - Fax:
Practice Address - Street 1:1315 BRIDGETOWN PIKE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4313
Practice Address - Country:US
Practice Address - Phone:215-364-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-02
Last Update Date:2011-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS038690122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist