Individual
DR. JASON G HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1801 N BELT W, SUITE C, BELLEVILLE, IL 62226-8201
(618) 234-6566
(618) 234-8560
Mailing address
1801 N BELT W, SUITE C, BELLEVILLE, IL 62226-8201
(618) 234-6566
(618) 234-8560
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019029875
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/13/2014
Last updated
01/13/2020
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