Healthcare Provider Details

I. General information

NPI: 1972298032
Provider Name (Legal Business Name): ZACHARY ALAN HATCH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 ROUTE 38
CHERRY HILL NJ
08002-2850
US

IV. Provider business mailing address

3183 E THOMPSON ST
PHILADELPHIA PA
19134-5127
US

V. Phone/Fax

Practice location:
  • Phone: 856-281-7600
  • Fax:
Mailing address:
  • Phone: 315-506-5833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDS044886
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: