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NPI Code Detail

MEDICARE: DR. MATTHEW T HARDEN DDS

MEDICARE: DR. MATTHEW T HARDEN DDS
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
1122300000XDentist2012015523MO

General Provider Information

NPI Number : 1528329281
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW T HARDEN DDS
Provider Business Mailing Address
First Line : 1916 N BALTIMORE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-1902
Country : US
Telephone Number : 660-666-1901
Fax Number : 660-665-1903
Provider Business Practice Location Address
First Line : 1916 N BALTIMORE ST
Second Line :
City : KIRKSVILLE
State : MO
Zip : 63501-1902
Country : US
Telephone Number : 660-666-1901
Fax Number : 660-665-1903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2012
Last Update Date : 06/02/2015

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