Provider Demographics
NPI:1649525973
Name:HARDMAN, PAUL DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DAVID
Last Name:HARDMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NMCSD BRANCH DENTAL CLINIC 32ND ST NAVAL BASE SAN DIEGO
Mailing Address - Street 2:2310 CRAVEN STREET
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92136
Mailing Address - Country:US
Mailing Address - Phone:619-556-8218
Mailing Address - Fax:619-556-9410
Practice Address - Street 1:NMCSD BRANCH DENTAL CLINIC 32ND
Practice Address - Street 2:2310 CRAVEN STREET
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92136-0001
Practice Address - Country:US
Practice Address - Phone:619-556-8218
Practice Address - Fax:619-556-9410
Is Sole Proprietor?:No
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program