Provider Demographics
NPI:1679956296
Name:EMILY HARDING DMD INC
Entity type:Organization
Organization Name:EMILY HARDING DMD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:ALLISON
Authorized Official - Last Name:HARDING
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:502-370-6463
Mailing Address - Street 1:2120 IVY RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-1736
Mailing Address - Country:US
Mailing Address - Phone:502-370-6463
Mailing Address - Fax:
Practice Address - Street 1:2120 IVY RD
Practice Address - Street 2:SUITE C
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-1736
Practice Address - Country:US
Practice Address - Phone:502-370-6463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401413096122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty