Healthcare Provider Details

I. General information

NPI: 1962837153
Provider Name (Legal Business Name): STEVEN L HATCHER DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2013
Last Update Date: 05/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2707 PINEDALE RD STE C
GREENSBORO NC
27408-2020
US

IV. Provider business mailing address

2707 PINEDALE RD STE C
GREENSBORO NC
27408-2020
US

V. Phone/Fax

Practice location:
  • Phone: 336-284-4022
  • Fax: 336-282-2437
Mailing address:
  • Phone: 336-282-4022
  • Fax: 336-282-2437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7439
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number7444
License Number StateNC

VIII. Authorized Official

Name: DR. STEVEN LEE HATCHER
Title or Position: PRESIDENT
Credential: DDS
Phone: 336-282-4022