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NPI Code Detail

MEDICARE: JOHN D HATCH JR DDS PC

MEDICARE: JOHN D HATCH JR DDS PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry2901010431MI

General Provider Information

NPI Number : 1124098918
Entity Type Code : Organization
Provider Name (Legal Business Name) : JOHN D HATCH JR DDS PC
Provider Business Mailing Address
First Line : 1240 N MAPLE RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48103-2842
Country : US
Telephone Number : 734-995-5191
Fax Number : 734-995-7079
Provider Business Practice Location Address
First Line : 1240 N MAPLE RD
Second Line :
City : ANN ARBOR
State : MI
Zip : 48103-2842
Country : US
Telephone Number : 734-995-5191
Fax Number : 734-995-7079
Authorized Official
Title or Position : PRESIDENT
Name : DR. JOHN DEVER HATCH
Credential : DDS
Telephone Number : 734-995-5791
Provider Enumeration Date : 01/24/2006
Last Update Date : 03/12/2013

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