Healthcare Provider Details

I. General information

NPI: 1679164032
Provider Name (Legal Business Name): STEPHANIE HARDING, DDS, A PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2021
Last Update Date: 01/28/2021
Certification Date: 01/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 STERLINGTON RD
MONROE LA
71203-2522
US

IV. Provider business mailing address

3340 STERLINGTON RD
MONROE LA
71203-2522
US

V. Phone/Fax

Practice location:
  • Phone: 318-325-2922
  • Fax:
Mailing address:
  • Phone: 318-325-2922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE HARDING
Title or Position: OWNER
Credential: DDS
Phone: 318-325-2922