Skip Navigation

Provider Information for 1316460009



DR. KAYCI M HARRIS DMD

Gender: FEMALE

Individual NPI: 1316460009

Calendar Last Updated: 2017-07-25

Details

Name Value
NPI 1316460009
Enumeration Date 2017-07-25
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address PO BOX 37
EMBUDO, NM 87531-0037
United States

Phone: 505-579-4680 | Fax: 505-579-4074
View Map External Link
Primary Practice Address 1102 STATE HIGHWAY 68
EMBUDO, NM 87531
United States

Phone: 505-579-4680 | Fax: 505-579-4074
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 122300000X - Dentist NM DD4761