Provider Demographics
NPI:1619305257
Name:HARDY DENTAL SPECIALISTS, PC
Entity Type:Organization
Organization Name:HARDY DENTAL SPECIALISTS, PC
Other - Org Name:TAFT HILL ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:720-308-1424
Mailing Address - Street 1:1015 S TAFT HILL RD
Mailing Address - Street 2:UNIT Q
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-4240
Mailing Address - Country:US
Mailing Address - Phone:970-980-2145
Mailing Address - Fax:970-980-2142
Practice Address - Street 1:1015 S TAFT HILL RD
Practice Address - Street 2:UNIT Q
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-4240
Practice Address - Country:US
Practice Address - Phone:970-980-2145
Practice Address - Fax:970-980-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN002020761223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty