Organization
HARVEST DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA BROCK (OPERATIONS MANAGER)
(903) 268-6542
Entity
Organization
Contact information
Practice address
1704 W AUDIE MURPHY PKWY, FARMERSVILLE, TX 75442-2753
(469) 812-7100
(469) 519-0610
Mailing address
1704 W AUDIE MURPHY PKWY, FARMERSVILLE, TX 75442-2753
(469) 812-7100
(469) 519-0610
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
28855
TX
261QD0000X
Dental Clinic/Center
Primary
28855
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3639437-01
—
TX
Enumeration date
06/16/2017
Last updated
06/16/2017
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