Provider Demographics
NPI:1699343608
Name:HARMON, ELIZABETH RICE (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RICE
Last Name:HARMON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LIBBY
Other - Middle Name:RICE
Other - Last Name:HARMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:12436 BREAKLINES ST APT 407
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-7681
Mailing Address - Country:US
Mailing Address - Phone:574-292-3652
Mailing Address - Fax:
Practice Address - Street 1:715 W CARMEL DR STE 103
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5881
Practice Address - Country:US
Practice Address - Phone:317-844-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013649A1223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health