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General NPI Number Information
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NPI Number | 1578902631
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Entity Type | Organization
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Legal Business Name | HATFIELD FAMILY & COSMETIC DENTISTRY
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Dates
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Enumeration Date | 06/21/2013
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Last Update Date | 06/21/2013
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Provider Practice Location Address
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Address Line | 301 THE PKWY
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City | GREER
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State | SC
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Zip | 29650-5221
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Country | US
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Telephone | 304-784-8813
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Fax |
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Provider Business Mailing Address
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Address Line | 301 THE PKWY
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City | GREER
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State | SC
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Zip | 29650-5221
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Country | US
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Telephone | 304-784-8813
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JOHNNA L HATFIELD
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Credential | DDS
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Telephone | 304-784-8813
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 8079
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License Number State | SC
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