Individual
DR. JEREMY ALAN HARDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
18471 WILTERS ST, ROBERTSDALE, AL 36567-6627
(251) 947-3636
(251) 947-3637
Mailing address
18471 WILTERS ST, ROBERTSDALE, AL 36567-6627
(251) 947-3636
(251) 947-3637
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
3371-06
MS
1223G0001X
General Practice Dentistry
Primary
5790 C1
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06377319
—
MS
Enumeration date
02/03/2009
Last updated
07/26/2010
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