Provider Demographics
NPI:1073057667
Name:HARDY SMILES PEDIATRIC DENTISTRY
Entity Type:Organization
Organization Name:HARDY SMILES PEDIATRIC DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:801-739-4446
Mailing Address - Street 1:3397 N 1200 E
Mailing Address - Street 2:SUITE 113
Mailing Address - City:LEHI
Mailing Address - State:UT
Mailing Address - Zip Code:84043-1594
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3397 N 1200 E
Practice Address - Street 2:SUITE 113
Practice Address - City:LEHI
Practice Address - State:UT
Practice Address - Zip Code:84043-1594
Practice Address - Country:US
Practice Address - Phone:801-331-8449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT79536911223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty