Provider Demographics
NPI:1841218476
Name:HARDIN, MICHAEL COLLINS (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:COLLINS
Last Name:HARDIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:636 US HIGHWAY #1
Mailing Address - Street 2:SUITE 217
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408
Mailing Address - Country:US
Mailing Address - Phone:561-844-1711
Mailing Address - Fax:561-844-5113
Practice Address - Street 1:636 US HIGHWAY #1
Practice Address - Street 2:SUITE 217
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408
Practice Address - Country:US
Practice Address - Phone:561-844-1711
Practice Address - Fax:561-844-5113
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice