Individual
HARLO LEE DONELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
125 S MAIN, MEMPHIS, MO 63555-1423
(660) 465-7770
(660) 465-7770
Mailing address
125 S MAIN, MEMPHIS, MO 63555-1423
(660) 465-7770
(660) 465-7770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10127
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0988022
—
IA
Enumeration date
05/06/2008
Last updated
05/06/2008
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