MEDICARE: DR. SCOTT HARDEN D.D.S.

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	1223G0001X	General Practice Dentistry	10630	GA

General Provider Information

NPI Number	:	1538210695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT HARDEN D.D.S.

Provider Business Mailing Address
First Line	:	904 VALLEY VISTA LN
Second Line	:
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-6776
Country	:	US
Telephone Number	:	770-926-0918
Fax Number	:

Provider Business Practice Location Address
First Line	:	1816 EAGLE DR
Second Line	:	BLDG 200 STE A
City	:	WOODSTOCK
State	:	GA
Zip	:	30189-8272
Country	:	US
Telephone Number	:	770-926-0000
Fax Number	:	770-924-0400

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

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. SCOTT HARDEN D.D.S.” Practice Location

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