Provider Demographics
NPI:1013616333
Name:FLOURISH TONGUE TIE CENTER, PLLC
Entity Type:Organization
Organization Name:FLOURISH TONGUE TIE CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NAMRATA
Authorized Official - Middle Name:G
Authorized Official - Last Name:HARDY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:720-900-3119
Mailing Address - Street 1:2005 TIVERTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-8157
Mailing Address - Country:US
Mailing Address - Phone:720-308-1424
Mailing Address - Fax:
Practice Address - Street 1:3200 VILLAGE VISTA DR UNIT 110
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:CO
Practice Address - Zip Code:80516-2596
Practice Address - Country:US
Practice Address - Phone:720-900-3119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty