Provider Demographics
NPI:1891812285
Name:CARY CHRISTIAN CENTER
Entity type:Organization
Organization Name:CARY CHRISTIAN CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:OLLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDAWAY
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:662-873-4593
Mailing Address - Street 1:154 COTTONWOOD
Mailing Address - Street 2:P.O. BOX 57
Mailing Address - City:CARY
Mailing Address - State:MS
Mailing Address - Zip Code:39054
Mailing Address - Country:US
Mailing Address - Phone:662-873-4593
Mailing Address - Fax:662-873-4112
Practice Address - Street 1:154 COTTONWOOD
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:MS
Practice Address - Zip Code:39054
Practice Address - Country:US
Practice Address - Phone:662-873-4593
Practice Address - Fax:662-873-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty