Healthcare Provider Details

I. General information

NPI: 1407151038
Provider Name (Legal Business Name): GEORGE P. HARDING D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2011
Last Update Date: 01/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3311 TOLEDO TER SUITE C203
HYATTSVILLE MD
20782-4135
US

IV. Provider business mailing address

3311 TOLEDO TER SUITE C203
HYATTSVILLE MD
20782-4135
US

V. Phone/Fax

Practice location:
  • Phone: 301-559-0404
  • Fax: 301-559-2058
Mailing address:
  • Phone: 301-559-0404
  • Fax: 301-559-2058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number07448
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number14735
License Number StateMD

VIII. Authorized Official

Name: DR. GEORGE P. HARDING
Title or Position: GENERAL DENTIST
Credential: D.D.S.
Phone: 301-559-0404