Provider Demographics
NPI:1285682781
Name:HARDEN, JOHN WESLEY JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WESLEY
Last Name:HARDEN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:550 PEACHTREE ST., NE
Mailing Address - Street 2:SUITE 1410
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2241
Mailing Address - Country:US
Mailing Address - Phone:404-523-6236
Mailing Address - Fax:404-526-9060
Practice Address - Street 1:550 PEACHTREE ST., NE
Practice Address - Street 2:SUITE 1410
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2241
Practice Address - Country:US
Practice Address - Phone:404-523-6236
Practice Address - Fax:404-526-9060
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA89461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice