MEDICARE: PAUL D HARDMAN DMD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center	6717	NV

General Provider Information

NPI Number	:	1306364625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAUL D HARDMAN DMD PC

Provider Business Mailing Address
First Line	:	1196 JASMINE LN
Second Line	:
City	:	FERNLEY
State	:	NV
Zip	:	89408-7217
Country	:	US
Telephone Number	:	503-706-8687
Fax Number	:

Provider Business Practice Location Address
First Line	:	804 E ROBINSON ST
Second Line	:
City	:	CARSON CITY
State	:	NV
Zip	:	89701-4734
Country	:	US
Telephone Number	:	775-883-7773
Fax Number	:

Authorized Official
Title or Position	:	DENTIST/PRESIDENT
Name	:	DR. PAUL DAVID HARDMAN
Credential	:	DMD
Telephone Number	:	503-706-8687

Provider Enumeration Date	:	09/07/2017
Last Update Date	:	09/07/2017

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