Provider Demographics
NPI:1770690059
Name:HARDING, LARUE WINSTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARUE
Middle Name:WINSTON
Last Name:HARDING
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SOUTH JACKSON HIGHWAY
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5769
Mailing Address - Country:US
Mailing Address - Phone:256-386-4073
Mailing Address - Fax:256-386-4077
Practice Address - Street 1:1100 SOUTH JACKSON HIGHWAY
Practice Address - Street 2:SUITE 103
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5769
Practice Address - Country:US
Practice Address - Phone:256-386-4073
Practice Address - Fax:256-386-4077
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3383122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist