Healthcare Provider Details

I. General information

NPI: 1598909525
Provider Name (Legal Business Name): LYNDA HARHAD DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3445 GOVERMENT ST
BATON ROUGE LA
70806
US

IV. Provider business mailing address

1090 NORTHCHASE PKWY SE SUITE 290
MARIETTA GA
30067-6405
US

V. Phone/Fax

Practice location:
  • Phone: 225-341-8332
  • Fax: 225-383-4130
Mailing address:
  • Phone: 770-916-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number6080
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: