Provider Demographics
NPI:1275734048
Name:DONALD L HARDEE DDS PA
Entity Type:Organization
Organization Name:DONALD L HARDEE DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARDEE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-756-6626
Mailing Address - Street 1:215 COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5029
Mailing Address - Country:US
Mailing Address - Phone:252-756-6626
Mailing Address - Fax:252-756-2147
Practice Address - Street 1:215 COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5029
Practice Address - Country:US
Practice Address - Phone:252-756-6626
Practice Address - Fax:252-756-2147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4645261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental