Provider Demographics
NPI:1679622260
Name:GASTON, HARPER (DDS)
Entity type:Individual
Prefix:DR
First Name:HARPER
Middle Name:
Last Name:GASTON
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 1:2211 CRESTMOOR RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2020
Mailing Address - Country:US
Mailing Address - Phone:615-383-3993
Mailing Address - Fax:615-383-2656
Practice Address - Street 1:2211 CRESTMOOR RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-2020
Practice Address - Country:US
Practice Address - Phone:615-383-3993
Practice Address - Fax:615-383-2656
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1659480804OtherNPI PRACTICE #