Provider Demographics
NPI:1902893118
Name:HARDMAN, STEVEN RANDALL (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:RANDALL
Last Name:HARDMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 817 BOX 32
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:09622-0032
Mailing Address - Country:US
Mailing Address - Phone:340-409-4375
Mailing Address - Fax:
Practice Address - Street 1:PSC 817 BOX 32
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:09622-0032
Practice Address - Country:US
Practice Address - Phone:340-409-4375
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14761122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist