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General NPI Number Information
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NPI Number | 1972031573
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Entity Type | Individual
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Provider Name | ELIZABETH R HATFIELD DDS
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Gender | Female
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Dates
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Enumeration Date | 05/25/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1500 E MEDICAL CENTER DR SPC 5831
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City | ANN ARBOR
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State | MI
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Zip | 48109-5000
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Country | US
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Telephone | 734-936-5950
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 E. MEDICAL CENTER DRIVE MEDINN CLINIC, C213 SPC 5831
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City | ANN ARBOR
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State | MI
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Zip | 48109-5831
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Country | US
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Telephone | 734-936-5950
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901022224
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License Number State | MI
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