Provider Demographics
NPI:1235947839
Name:HARDY, COLBI BROOKE (RDH, BSDH)
Entity type:Individual
Prefix:
First Name:COLBI
Middle Name:BROOKE
Last Name:HARDY
Suffix:
Gender:F
Credentials:RDH, BSDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 BELL RD APT 1128
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-7359
Mailing Address - Country:US
Mailing Address - Phone:931-205-1588
Mailing Address - Fax:
Practice Address - Street 1:104 EASTPARK DR STE 201
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-7535
Practice Address - Country:US
Practice Address - Phone:615-373-8307
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN10481124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist