Individual
DR. JACK BENJAMIN HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4611 ARROYO DR, SUITE 1, CASPER, WY 82604-5116
(307) 235-1600
Mailing address
4611 ARROYO DR, SUITE 1, CASPER, WY 82604-5116
(307) 235-1600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
57754
CA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
WY1265
WY
Other
Enumeration date
12/16/2008
Last updated
12/07/2015
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