Organization
MARTHA HARDAWAY DMD MS PA
Active
Other names
Bluebird Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA HARDAWAY DMD MS (PRESIDENT)
(919) 604-1546
Entity
Organization
Contact information
Practice address
247 MOUNT JEFFERSON STATE PARK RD STE 7, WEST JEFFERSON, NC 28694-8042
(919) 604-1546
Mailing address
176 WIND WALKER CT, BOONE, NC 28607-5349
(919) 604-1546
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5909845
—
NC
Enumeration date
03/24/2021
Last updated
03/24/2021
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