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General NPI Number Information
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NPI Number | 1508285552
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Entity Type | Individual
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Provider Name | NATHAN M HAWES D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 1721 PROGRESSIVE PKWY
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City | PLATTEVILLE
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State | WI
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Zip | 53818-0501
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Country | US
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Telephone | 608-348-9591
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 PROGRESSIVE PKWY PO BOX 501
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City | PLATTEVILLE
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State | WI
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Zip | 53818-0501
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Country | US
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Telephone | 608-348-9591
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 100189-15
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License Number State | WI
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