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DR. JEREMY ALAN HARDY D.M.D.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1124266887

Individual Registrant:
DR. JEREMY ALAN HARDY D.M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
18471 WILTERS ST  ROBERTSDALE, AL 36567-6627 US
Tel: 251-947-3636  Fax: 251-947-3637

Contact information for business:
18471 WILTERS ST  ROBERTSDALE, AL 36567-6627 US
Tel: 251-947-3636  Fax: 251-947-3637

Registration Information:
NPI: 1124266887
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N1223G0001XDental Providers
Dentist
General Practice
MS3371-06
Y1223G0001XDental Providers
Dentist
AL5790 C1

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
06377319MS05




HEALTH CARE JOBS AL - Page 1



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