Organization
JASON R. HARRIS DDS, PA
Active
Other names
Southern Village Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON ROBERT HARRIS DDS (DENTIST/OWNER)
(252) 213-2545
Entity
Organization
Contact information
Practice address
8838 US 70 HWY W, SUITE 100, CLAYTON, NC 27520-4822
(919) 550-8171
Mailing address
8838 US 70 HWY W, SUITE 100, CLAYTON, NC 27520-4822
(919) 550-8171
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
9744
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9744
NC DENTAL LICENSE NUMBER
NC
Enumeration date
07/27/2016
Last updated
07/27/2016
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