Provider Demographics
NPI:1982752432
Name:GGARDEN, JAMES RALPH
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RALPH
Last Name:GGARDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 PLANTATION CENTER DR
Mailing Address - Street 2:8161 ARDREY KELL RD.-CHARLOTTE NC-
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5298
Mailing Address - Country:US
Mailing Address - Phone:704-845-5583
Mailing Address - Fax:704-814-9275
Practice Address - Street 1:2505 PLANTATION CENTER DR
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5298
Practice Address - Country:US
Practice Address - Phone:704-845-5583
Practice Address - Fax:704-814-9275
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice