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NPI 1003432709

NPI 1003432709 : RALPH DONALD HAWKINS DDS : BONNEY LAKE, WA

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General NPI Number Information
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    NPI Number           |    1003432709
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    Entity Type          |    Individual 
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    Provider Name        |    RALPH DONALD HAWKINS DDS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/18/2020
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    Last Update Date     |    06/18/2020
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Provider Practice Location Address
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    Address Line         |    14921 182ND AVE E 
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    City                 |    BONNEY LAKE
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    State                |    WA
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    Zip                  |    98391-8240
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    Country              |    US
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    Telephone            |    949-324-8818
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    14921 182ND AVE E 
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    City                 |    BONNEY LAKE
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    State                |    WA
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    Zip                  |    98391-8240
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    Country              |    US
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    Telephone            |    949-324-8818
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223E0200X
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    Taxonomy Name        |    Endodontics
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    License Number       |    28447
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    License Number State |    CA
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