Organization
HARDIE DENTISTRY FOR KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIE M HARDIE DDS (PEDIATRIC DENTIST/ OWNER)
(360) 241-4361
Entity
Organization
Contact information
Practice address
925 NE 136TH AVE, SUITE 101, VANCOUVER, WA 98684-0896
(360) 694-5559
(360) 694-5557
Mailing address
12800 NE 4TH ST, APT 58, VANCOUVER, WA 98684-5051
(360) 241-4361
(360) 964-5557
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE00008741
WA
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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