# CHARLES E. HARRIS DDS, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326259367
- **Authorized official:** DR. CHARLES EDWARD HARRIS DDS (PRESIDENT)
- **Authorized official phone:** (540) 951-3989

## Contact information

- **Practice address:** 210 PROFESSIONAL PARK DR SE, SUITE 11, BLACKSBURG, VA 24060-6680
- **Practice address phone:** (540) 951-3989
- **Practice address fax:** (540) 951-0273
- **Mailing address:** 210 PROFESSIONAL PARK DR SE, SUITE 11, BLACKSBURG, VA 24060-6680
- **Mailing address phone:** (540) 951-3989
- **Mailing address fax:** (540) 951-0273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 0401005520 | VA | Yes |

## Other

- **Enumeration date:** 05/24/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 067063 | ANTHEM PROVIDER NUMBER | VA |