DR. Ollie Hardaway JR., D.D.S.
NPI #1063539138 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1063539138
- Entity Type
- Individual
- Name
- DR. Ollie Hardaway JR., D.D.S.
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist
- Credential
- D.D.S.
- Enumeration Date
- Mar 23, 2007
- Last Updated
- Dec 17, 2007
Practice Location
- Address
- 154 COTTONWOOD STREET
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180
- Phone
- (662) 873-4593
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
| Dentist - General Practice — General Practice |
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