MEDICARE: STEPHEN F HARDY 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	122300000X	Dentist	3803	AZ

General Provider Information

NPI Number	:	1558371476
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN F HARDY DMD PC

Provider Business Mailing Address
First Line	:	1930 W THUNDERBIRD RD
Second Line	:	SUITE 116
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6369
Country	:	US
Telephone Number	:	602-993-3744
Fax Number	:	602-993-3745

Provider Business Practice Location Address
First Line	:	1930 W THUNDERBIRD RD
Second Line	:	SUITE 116
City	:	PHOENIX
State	:	AZ
Zip	:	85023-6369
Country	:	US
Telephone Number	:	602-993-3744
Fax Number	:	602-993-3745

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHEN FRANCIS HARDY
Credential	:	DMD
Telephone Number	:	602-993-3744

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	08/22/2020

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