Republic Dental Clinic

NPI #1164749396 in Republic, Washington

Provider Information

NPI Number: 1164749396
Entity Type: Organization
Organization Name: Republic Dental Clinic
Primary Specialty: Dentist
Enumeration Date: Apr 28, 2010
Last Updated: Apr 28, 2010

Practice Location

Address: 194 N. PORTLAND ST.
City: Republic
State: Washington
ZIP Code: 99166-0978
Phone: (509) 775-3169

Authorized Official

Name: DR. ROBERT W. HARDWICK JR., D.D.S.
Title: OWNER/DENTIST
Phone: (509) 775-3169

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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