Provider Demographics
NPI:1689719668
Name:HARDIE, RICH (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RICH
Middle Name:
Last Name:HARDIE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:RICHARDSON
Other - Last Name:HARDIE
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:910 E GRAND AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3430
Mailing Address - Country:US
Mailing Address - Phone:760-746-3450
Mailing Address - Fax:760-746-3583
Practice Address - Street 1:910 E GRAND AVE
Practice Address - Street 2:SUITE E
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-3430
Practice Address - Country:US
Practice Address - Phone:760-746-3450
Practice Address - Fax:760-746-3583
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA392721223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics