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Organization
HARRISON W. GOLLOB DMD PA
Active
Organization
HARRISON W. GOLLOB DMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRISON W GOLLOB DMD (PRESIDENT)
(404) 319-0919
Entity
Organization
Contact information
Practice address
130 INTERLACHEN RD STE A, MELBOURNE, FL 32940-1994
(404) 319-0919
Mailing address
130 INTERLACHEN RD STE A, MELBOURNE, FL 32940-1994
(404) 319-0919
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
08/17/2021
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