Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DN0007304 | FL |
NPI | 1215945449 |
---|---|
Provider Name | Dr. Harty B Mercer |
First Address | Fort Myers, FL 33912-5754 |
Second Address | Fort Myers, FL 33908-4297 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 09/07/2007 |