Provider Demographics
NPI:1669064341
Name:STEPHEN HARWARD, DMD, PLLC
Entity type:Organization
Organization Name:STEPHEN HARWARD, DMD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARWARD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:984-465-1544
Mailing Address - Street 1:3490 KILDAIRE FARM RD STE 170
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27518-2287
Mailing Address - Country:US
Mailing Address - Phone:984-465-1544
Mailing Address - Fax:
Practice Address - Street 1:3490 KILDAIRE FARM RD STE 170
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27518-2287
Practice Address - Country:US
Practice Address - Phone:919-659-5155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1962995035OtherDENTIST/GENERAL PRACTICE
NC1962995035OtherDENTIST/GENERAL PRACTICE