Individual
BLAKE HARDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4041 PARNELL AVE, FORT WAYNE, IN 46805-1413
(260) 482-8386
Mailing address
2614 ABBEY DR APT 5, FORT WAYNE, IN 46835-3115
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12011188A
IN
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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