| Harden Family Dentistry Pc | |
|
7411 John R St Detroit MI 48202-3117 | |
| (313) 871-4405 | |
| (313) 429-7531 |
| Full Name | Harden Family Dentistry Pc |
|---|---|
| Speciality | Dentist |
| Location | 7411 John R St, Detroit, Michigan |
| Authorized Official Name and Position | Kenneth J Harden (GENERAL DENTIST) |
| Authorized Official Contact | 3138714405 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harden Family Dentistry Pc 7411 John R St Detroit MI 48202-3117 Ph: (313) 871-4405 | Harden Family Dentistry Pc 7411 John R St Detroit MI 48202-3117 Ph: (313) 871-4405 |
| NPI Number | 1720529621 |
|---|---|
| Provider Enumeration Date | 03/13/2017 |
| Last Update Date | 12/08/2017 |
| Medicare PECOS PAC ID | 9234497462 |
|---|---|
| Medicare Enrollment ID | O20171218001018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720529621 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 13687 (Michigan) | Primary |
| Provider Name | Kenneth J Harden |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1639389299 PECOS PAC ID: 6608194675 Enrollment ID: I20180219000749 |
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