MEDICARE: DR. ROBERT HARDY D.M.D.

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	30.021550	OH

General Provider Information

NPI Number	:	1407074727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT HARDY D.M.D.

Provider Business Mailing Address
First Line	:	4199 GANTZ RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2993
Country	:	US
Telephone Number	:	614-871-8200
Fax Number	:	614-871-8300

Provider Business Practice Location Address
First Line	:	4199 GANTZ RD
Second Line	:
City	:	GROVE CITY
State	:	OH
Zip	:	43123-2993
Country	:	US
Telephone Number	:	614-871-8200
Fax Number	:	614-871-8300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	07/08/2007

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