Individual
MARK LEROY HARRIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1809 3RD ST, LA GRANDE, OR 97850-2244
(541) 963-0924
(541) 962-0924
Mailing address
1805 HIGHLAND DR, LA GRANDE, OR 97850-3209
(541) 962-0493
(541) 962-0924
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6922
OR
Other
Enumeration date
07/08/2005
Last updated
07/08/2007
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