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Provider Information for 1144252818



DR. KELLIE ANN HARRIS D.D.S, F.A.G.D

Gender: FEMALE

Individual NPI: 1144252818

Calendar Last Updated: 2007-07-08

Details

Name Value
NPI 1144252818
Enumeration Date 2006-07-06
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1337 GUSDORF RD SUITE A
TAOS, NM 87571-6294
United States

Phone: 505-751-9661 | Fax: 505-751-9689
View Map External Link
Primary Practice Address 1337 GUSDORF RD SUITE A
TAOS, NM 87571-6294
United States

Phone: 505-751-9661 | Fax: 505-751-9689
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NM DD1953