Individual
DR. JEFFREY JUSTIN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1630 MARKET CENTER DR, SUITE 100, O FALLON, MO 63368-8407
(636) 300-4380
Mailing address
2006 MAURY AVE, APT 1 SOUTH, SAINT LOUIS, MO 63110-3243
(314) 504-0683
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2009014633
MO
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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