Individual
DR. HARRISON WILLIAM GOLLOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
130 INTERLACHEN RD STE A, MELBOURNE, FL 32940-1994
(321) 255-4644
Mailing address
130 INTERLACHEN RD STE A, MELBOURNE, FL 32940-1994
(321) 255-4644
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN20164
FL
Other
Enumeration date
06/17/2013
Last updated
10/13/2021
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