Individual
DR. KEVIN CHARLES HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.
Contact information
Practice address
10151 MONTGOMERY BLVD NE STE C, ALBUQUERQUE, NM 87111-3670
(505) 275-1662
Mailing address
10151 MONTGOMERY BLVD NE STE C, ALBUQUERQUE, NM 87111-3670
(505) 275-1662
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DD3470
NM
Other
Enumeration date
06/07/2011
Last updated
06/07/2011
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