# HARVEST DENTAL, PLLC

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

## Provider details

- **NPI number:** 1629508130
- **Authorized official:** MRS. BRENDA BROCK (OPERATIONS MANAGER)
- **Authorized official phone:** (903) 268-6542

## Contact information

- **Practice address:** 1704 W AUDIE MURPHY PKWY, FARMERSVILLE, TX 75442-2753
- **Practice address phone:** (469) 812-7100
- **Practice address fax:** (469) 519-0610
- **Mailing address:** 1704 W AUDIE MURPHY PKWY, FARMERSVILLE, TX 75442-2753
- **Mailing address phone:** (469) 812-7100
- **Mailing address fax:** (469) 519-0610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 28855 | TX | — |
| 261QD0000X | Dental Clinic/Center | 28855 | TX | Yes |

## Other

- **Enumeration date:** 06/16/2017
- **Last updated:** 06/16/2017