Individual
DR. DOUGLAS R HARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2801 FAIRVIEW PL, SUITE U, GREENWOOD, IN 46142-1310
(317) 881-1680
(317) 881-0603
Mailing address
2801 FAIRVIEW PL, SUITE U, GREENWOOD, IN 46142-1310
(317) 881-1680
(317) 881-0603
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12008501B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100124790A
—
IN
Enumeration date
08/17/2006
Last updated
03/09/2020
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