person
Willie M Hardie, DDS
Pediatric Dentist in Vancouver, Washington
NPI 1093891533

Willie M Hardie is a Pediatric Dentist based in Vancouver, WA and is specialized in Pediatric Dentistry. Willie M Hardie practices in Vancouver, WA and has the professional credentials of DDS. The NPI Number for Willie M Hardie is 1093891533 and holds a License No. DE00008741 (Washington).

The current practice location address for Willie M Hardie is 925 Ne 136Th Ave, Vancouver, WA and can be reached out via phone at 360-694-5559 and via fax at 360-891-0000.

Location: 925 Ne 136Th Ave, Vancouver, WA, 98684-0896
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Provider Profile Details
NPI Number
1093891533
Provider Name
Willie M Hardie
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
925 Ne 136Th Ave, Vancouver, WA, 98684-0896
Phone Number
360-694-5559
Fax Number
360-891-0000
Provider Enumeration Date
10/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2007980 01 WA GROUP MEDICAID
1002369 05 WA
institution
Provider Business Practice Location Address Details
Address
925 Ne 136Th Ave
City
State
Zip
98684-0896
Phone Number
360-694-5559
Fax Number
360-891-0000
person
Provider Business Mailing Address Details
Address
925 Ne 136Th Ave
City
State
Zip
98684-0896
Phone Number
360-694-5559
Fax Number
360-891-0000
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
License No.
DE00008741 (Washington)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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