Organization
PEDIATRIC DENTAL SPECIALISTS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN T HARRIS DDS (OWNER)
(903) 892-1200
Entity
Organization
Contact information
Practice address
2921 N HERITAGE PARKWAY, STE 100, SHERMAN, TX 75092
(903) 892-1200
(903) 813-1581
Mailing address
2921 N HERITAGE PARKWAY, STE 100, SHERMAN, TX 75092
(903) 892-1200
(903) 813-1581
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18321
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0093EX
BLUE CROSS BLUE SHIELD
TX
01
—
817302
UNITED CONCORDIA
TX
Enumeration date
06/14/2005
Last updated
02/04/2009
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