Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DE00007743 | WA |
NPI | 1164462727 |
---|---|
Provider Name | Dr. Charles Kennett Harvey |
First Address | Silverdale, WA 98383-3710 |
Second Address | Silverdale, WA 98383 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 08/07/2007 |