NPI 1174906911

Jessica L. Hardy, DDS, PA

Organisation General Practice Dentistry Moorhead, MN

Practice location

Address: 320 2nd Ave S STE 106, Moorhead, MN 56560-2602
Phone: (218) 236-1666

Authorised official

Name: Deborah Osmundson
Title: Office Manager
Phone: (218) 236-1666

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence D13580 (MN)

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Registry record

NPI: 1174906911
Entity type: Organization
NPI issued: 29 Jun 2015
Record last updated: 12 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.