# DAVID K. HARRISON DDS PC

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

## Provider details

- **NPI number:** 1831279447
- **Authorized official:** DAVID K HARRISON (OWNER)
- **Authorized official phone:** (260) 747-4747

## Contact information

- **Practice address:** 6412 WINCHESTER RD, FORT WAYNE, IN 46819-1550
- **Practice address phone:** (260) 747-4747
- **Practice address fax:** (260) 747-4749
- **Mailing address:** 6412 WINCHESTER RD, FORT WAYNE, IN 46819-1550
- **Mailing address phone:** (260) 747-4747
- **Mailing address fax:** (260) 747-4749

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12008577 | IN | Yes |

## Other

- **Enumeration date:** 10/17/2006
- **Last updated:** 02/27/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100079930 | — | IN |