Provider Demographics
NPI:1437235918
Name:HARPER, MICHAEL R (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:HARPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21202 OLEAN BLVD E-2
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33952
Mailing Address - Country:US
Mailing Address - Phone:941-629-3200
Mailing Address - Fax:941-629-2113
Practice Address - Street 1:21202 OLEAN BLVD
Practice Address - Street 2:E-2
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-6751
Practice Address - Country:US
Practice Address - Phone:941-629-3200
Practice Address - Fax:941-629-2113
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 85391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDN 8539OtherDENTAL LICENSE