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Organization

CHARLES E. HARRIS DDS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES EDWARD HARRIS DDS (PRESIDENT)
(540) 951-3989
Entity
Organization

Contact information

Practice address
210 PROFESSIONAL PARK DR SE, SUITE 11, BLACKSBURG, VA 24060-6680
(540) 951-3989
(540) 951-0273
Mailing address
210 PROFESSIONAL PARK DR SE, SUITE 11, BLACKSBURG, VA 24060-6680
(540) 951-3989
(540) 951-0273

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005520
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
067063
ANTHEM PROVIDER NUMBER
VA
Enumeration date
05/24/2007
Last updated
08/22/2020
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