Individual
DR. KEITH HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
6412 WINCHESTER RD, FORT WAYNE, IN 46819-1550
(260) 747-4747
(260) 747-4749
Mailing address
6412 WINCHESTER RD, FORT WAYNE, IN 46819-1550
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12011823A
IN
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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