Provider Demographics
NPI:1154050805
Name:HARDY, VICTORIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 N B ST
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-9309
Mailing Address - Country:US
Mailing Address - Phone:252-578-6263
Mailing Address - Fax:
Practice Address - Street 1:306 PENNY LN
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4306
Practice Address - Country:US
Practice Address - Phone:252-247-6704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12782122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist