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General NPI Number Information
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NPI Number | 1033677901
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Entity Type | Organization
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Legal Business Name | C. HASTINGS, DDS, LLC
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Dates
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Enumeration Date | 03/08/2019
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Last Update Date | 02/01/2020
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Provider Practice Location Address
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Address Line | 1709 HERITAGE HILLS DR
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City | WASHINGTON
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State | MO
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Zip | 63090-4621
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Country | US
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Telephone | 314-496-3562
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Fax |
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Provider Business Mailing Address
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Address Line | 309 CEDAR ST
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City | WASHINGTON
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State | MO
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Zip | 63090-2324
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Country | US
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Telephone | 314-496-3562
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. COREY HASTINGS
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Credential | DDS, MS
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Telephone | 314-496-3562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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