Provider Demographics
NPI:1447343918
Name:HARDEMAN, JOHN HOWARD (MD, DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HOWARD
Last Name:HARDEMAN
Suffix:
Gender:M
Credentials:MD, DDS
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Other - First Name:
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Mailing Address - Street 1:1600 SW ARCHER RD
Mailing Address - Street 2:BOX 100425
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0405
Mailing Address - Country:US
Mailing Address - Phone:352-273-6750
Mailing Address - Fax:352-392-7609
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:BOX 100425
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-0405
Practice Address - Country:US
Practice Address - Phone:352-273-6750
Practice Address - Fax:352-392-7609
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLDN 129101223S0112X
FLME59580204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery