Provider Demographics
NPI:1558371476
Name:STEPHEN F HARDY DMD PC
Entity Type:Organization
Organization Name:STEPHEN F HARDY DMD PC
Other - Org Name:MOON VALLEY FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:602-993-3744
Mailing Address - Street 1:1930 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85023-6369
Mailing Address - Country:US
Mailing Address - Phone:602-993-3744
Mailing Address - Fax:602-993-3745
Practice Address - Street 1:1930 W THUNDERBIRD RD
Practice Address - Street 2:SUITE 116
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-6369
Practice Address - Country:US
Practice Address - Phone:602-993-3744
Practice Address - Fax:602-993-3745
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3803122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty