Provider Demographics
NPI:1376902296
Name:HARKINS, CLAIRE STEWART (DMD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:STEWART
Last Name:HARKINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:CLAIRE
Other - Middle Name:VIRGINIA
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 CHICOT CV
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-8669
Mailing Address - Country:US
Mailing Address - Phone:601-291-9299
Mailing Address - Fax:
Practice Address - Street 1:1476 W GOVERNMENT ST STE A
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39042-3051
Practice Address - Country:US
Practice Address - Phone:601-724-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-20
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3878-16122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist