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NPI 1720701469

NPI 1720701469 : STEPHANIE HARDING, DDS OF MISSISSIPPI II, PLLC : TUPELO, MS

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General NPI Number Information
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    NPI Number           |    1720701469
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    Entity Type          |    Organization 
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    Legal Business Name  |    STEPHANIE HARDING, DDS OF MISSISSIPPI II, PLLC 
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Dates
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    Enumeration Date     |    09/19/2022
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    Last Update Date     |    09/19/2022
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Provider Practice Location Address
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    Address Line         |    837 S GLOSTER ST 
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    City                 |    TUPELO
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    State                |    MS
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    Zip                  |    38801-4933
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    Country              |    US
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    Telephone            |    662-844-6767
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    837 S GLOSTER ST 
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    City                 |    TUPELO
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    State                |    MS
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    Zip                  |    38801-4933
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    Country              |    US
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    Telephone            |    662-844-6767
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ENROLLMENT SPECIALIST
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    Name                 |     HALEY  WOOSTER 
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    Credential           |    
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    Telephone            |    712-733-8551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    
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    License Number State |    
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