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General NPI Number Information
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NPI Number | 1780764993
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Entity Type | Organization
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Legal Business Name | HATCHER AND BOMSTAD DDS LLC
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Dates
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Enumeration Date | 10/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 911 FIRST ST NORTH
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City | HOPKINS
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State | MN
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Zip | 55343-7526
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Country | US
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Telephone | 952-938-7746
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Fax | 952-938-1511
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Provider Business Mailing Address
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Address Line | 911 FIRST ST NORTH
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City | HOPKINS
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State | MN
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Zip | 55343-7526
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Country | US
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Telephone | 952-938-7746
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Fax | 952-938-1511
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Authorized Official
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Title or Position | OWNER PARTNER
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Name | ALAN S HATCHER
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Credential | DDS
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Telephone | 952-938-7746
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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 |
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License Number State | MN
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