Individual
WILLIAM JOSEPH HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
1 E MAIN ST, FRANKLIN, ID 83237-5115
(208) 646-2211
Mailing address
22 N STATE ST, FRANKLIN, ID 83237-5094
(208) 646-2211
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
LD-39
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001863100
—
ID
Enumeration date
06/29/2009
Last updated
06/29/2009
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