Provider Demographics
NPI:1932248416
Name:HARROZ, EDWARD JR (DDS)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:HARROZ
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:PO BOX 30078
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73140-3078
Mailing Address - Country:US
Mailing Address - Phone:405-737-5905
Mailing Address - Fax:405-739-0328
Practice Address - Street 1:7215 E RENO AVE
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4446
Practice Address - Country:US
Practice Address - Phone:405-737-5905
Practice Address - Fax:405-739-0328
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK42401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice