Provider Demographics
NPI:1255396230
Name:HARDING, LEE WILLIAM (DDS)
Entity type:Individual
Prefix:DR
First Name:LEE
Middle Name:WILLIAM
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 1:18202 SANTA ALBERTA LN
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85338-5342
Mailing Address - Country:US
Mailing Address - Phone:623-386-9386
Mailing Address - Fax:
Practice Address - Street 1:18202 SANTA ALBERTA LN
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-5342
Practice Address - Country:US
Practice Address - Phone:623-386-9386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ53761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice