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Individual

DR. JODY SCOTT HARRISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4700 LAS VEGAS BLVD, NELLIS AFB, NV 89191-6601
(702) 653-3148
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-3148

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
21129
TX

Other

Enumeration date
05/01/2007
Last updated
02/14/2014
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