Healthcare Provider Details

I. General information

NPI: 1265395693
Provider Name (Legal Business Name): HART INDUSTRIES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 S 4TH AVE
HARTFORD AL
36344-1616
US

IV. Provider business mailing address

209 S 4TH AVE
HARTFORD AL
36344-1616
US

V. Phone/Fax

Practice location:
  • Phone: 334-588-6684
  • Fax: 334-588-2903
Mailing address:
  • Phone: 334-588-6684
  • Fax: 334-588-2903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: KIRBY HART
Title or Position: OWNER
Credential: DMD
Phone: 334-588-6684