Individual
DR. JUSTIN HARDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D, M.S.D
Contact information
Practice address
7915 LAKE MANASSAS DR STE 207, GAINESVILLE, VA 20155-3260
(571) 261-4867
Mailing address
7915 LAKE MANASSAS DR STE 207, GAINESVILLE, VA 20155-3260
(571) 261-4867
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401413670
VA
1223P0300X
Periodontics
0442000102
VA
Other
Enumeration date
08/10/2010
Last updated
02/28/2023
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