Individual
PHILLIP JAMES HARAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
128 MARKET STREET, ALAMOSA, CO 81101
(719) 589-9691
(719) 587-9148
Mailing address
128 MARKET STREET, ALAMOSA, CO 81101
(719) 589-5161
(719) 589-5722
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
788
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02007888
—
CO
Enumeration date
01/08/2008
Last updated
02/26/2008
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