MEDICARE: DR. NAMRATA GUPTE HARDY DMD

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	1223P0221X	Pediatric Dentistry	DEN.00202275	CO

General Provider Information

NPI Number	:	1801153101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAMRATA GUPTE HARDY DMD

Provider Business Mailing Address
First Line	:	3200 VILLAGE VISTA DR
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-2521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 VILLAGE VISTA DR
Second Line	:
City	:	ERIE
State	:	CO
Zip	:	80516-2521
Country	:	US
Telephone Number	:	720-900-3119
Fax Number	:

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

Provider Enumeration Date	:	04/12/2012
Last Update Date	:	02/02/2018

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