Individual
DR. BRENDON LUTHER HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
102 HYDE PKWY, PALMYRA, NY 14522-1210
(315) 597-5511
Mailing address
102 HYDE PKWY, PALMYRA, NY 14522-1210
(315) 597-5511
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
056800
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2012
Last updated
10/30/2017
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