MEDICARE: DR. JOHN DANIEL HATCHER D.D.S., P.C.

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
1	1223G0001X	General Practice Dentistry	14516	TX

General Provider Information

NPI Number	:	1386670214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN DANIEL HATCHER D.D.S., P.C.

Provider Business Mailing Address
First Line	:	3421 BURKE RD
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1975
Country	:	US
Telephone Number	:	713-944-2836
Fax Number	:	713-944-8620

Provider Business Practice Location Address
First Line	:	3421 BURKE RD
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1975
Country	:	US
Telephone Number	:	713-944-2836
Fax Number	:	713-944-8620

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/23/2006
Last Update Date	:	07/08/2007

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