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General NPI Number Information
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NPI Number | 1700533445
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Entity Type | Individual
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Provider Name | ROBIN HARDING RDH
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Gender | Female
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Dates
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Enumeration Date | 03/02/2022
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 4060 S LAKE DR APT 4
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City | SAINT FRANCIS
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State | WI
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Zip | 53235-5256
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Country | US
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Telephone | 407-375-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 STORDEUR DR
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City | GREEN BAY
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State | WI
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Zip | 54313-4231
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Country | US
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Telephone | 906-285-0276
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 10554-16
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License Number State | WI
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