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General NPI Number Information
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NPI Number | 1508252818
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Entity Type | Organization
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Legal Business Name | BENJAMIN HARDYK, DDS, P.C.
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 2170 MAIN ST STE E
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City | OAKLEY
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State | CA
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Zip | 94561-3350
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Country | US
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Telephone | 323-401-6663
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Fax |
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Provider Business Mailing Address
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Address Line | 2170 MAIN ST STE E
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City | OAKLEY
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State | CA
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Zip | 94561-3350
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BENJAMIN HARDYK
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Credential | DDS
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Telephone | 323-401-6663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 62418
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License Number State | CA
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