Individual
DR. LANCE HERSCHEL HARRISON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
7725 LAKE WORTH RD STE 7729, LAKE WORTH, FL 33467-2536
(561) 359-6483
Mailing address
813 PARK DR, GOODLETTSVILLE, TN 37072-3147
(561) 388-5819
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
053622
NY
122300000X
Dentist
8737
TN
122300000X
Dentist
Primary
DN27515
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5442012
—
TN
Enumeration date
10/29/2007
Last updated
03/10/2023
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