Provider Demographics
NPI:1750793758
Name:HARLOW, HOWARD JUSTIN (DDS)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:JUSTIN
Last Name:HARLOW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10922 S TRYON ST STE D
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-4152
Mailing Address - Country:US
Mailing Address - Phone:704-588-1515
Mailing Address - Fax:704-588-1514
Practice Address - Street 1:10922 S TRYON ST STE D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-4152
Practice Address - Country:US
Practice Address - Phone:704-588-1515
Practice Address - Fax:704-588-1514
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC97431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1750793758Medicaid