Healthcare Provider Details

I. General information

NPI: 1700017738
Provider Name (Legal Business Name): WILLIAM F. HAST D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2009
Last Update Date: 11/08/2022
Certification Date: 11/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 CUMBERLAND FALLS HWY STE D141
CORBIN KY
40701-2796
US

IV. Provider business mailing address

390 TALON TRL
LONDON KY
40744-6312
US

V. Phone/Fax

Practice location:
  • Phone: 606-528-5527
  • Fax:
Mailing address:
  • Phone: 606-878-7428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5498
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: