Provider Demographics
NPI:1013394709
Name:HARDIN, TODD (DDS)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:HARDIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WALTER SCHOLER DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909
Mailing Address - Country:US
Mailing Address - Phone:765-477-6100
Mailing Address - Fax:
Practice Address - Street 1:2 WALTER SCHOLER DRIVE
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47909
Practice Address - Country:US
Practice Address - Phone:765-477-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-01
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12011194A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist