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DR. MARTY JOE HARDERSON D.D.S.

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1598701807

Individual Registrant:
DR. MARTY JOE HARDERSON D.D.S.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
126 S.MAIN .  LEACHVILLE, AR 72438-0109 US
Tel: 870-539-6621  Fax: 870-539-6334

Contact information for business:
P.O. BOX 109  LEACHVILLE, AR 72438 US
Tel: 870-539-6621  Fax: 870-539-6334

Registration Information:
NPI: 1598701807
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
AR2952

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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