MEDICARE: DR. JOHN WESLEY HARDEN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4217	SC

General Provider Information

NPI Number	:	1427195346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN WESLEY HARDEN DMD

Provider Business Mailing Address
First Line	:	701 SULPHUR SPRINGS RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29617-1913
Country	:	US
Telephone Number	:	864-246-2181
Fax Number	:	864-246-6780

Provider Business Practice Location Address
First Line	:	701 SULPHUR SPRINGS RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29617-1913
Country	:	US
Telephone Number	:	864-246-2181
Fax Number	:	864-246-6780

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	07/08/2007

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