# REPUBLIC DENTAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rob Hardwick, D.D.S.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164749396
- **Authorized official:** DR. ROBERT W. HARDWICK JR. D.D.S. (OWNER/DENTIST)
- **Authorized official phone:** (509) 775-3169

## Contact information

- **Practice address:** 194 N. PORTLAND ST., REPUBLIC, WA 99166-0978
- **Practice address phone:** (509) 775-3169
- **Practice address fax:** (509) 775-2272
- **Mailing address:** PO BOX 978, REPUBLIC, WA 99166-0978
- **Mailing address phone:** (509) 775-3169
- **Mailing address fax:** (509) 775-2272

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5070 | WA | Yes |

## Other

- **Enumeration date:** 04/28/2010
- **Last updated:** 04/28/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5027230 | — | WA |