Provider Demographics
NPI:1053491894
Name:SHAYLAR HATCH, D.M.D., P.C.
Entity Type:Organization
Organization Name:SHAYLAR HATCH, D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAYLAR
Authorized Official - Middle Name:
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:480-525-6000
Mailing Address - Street 1:4135 S POWER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85212-3625
Mailing Address - Country:US
Mailing Address - Phone:480-525-6000
Mailing Address - Fax:480-525-6001
Practice Address - Street 1:4135 S POWER RD STE 101
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85212-3625
Practice Address - Country:US
Practice Address - Phone:480-525-6000
Practice Address - Fax:480-525-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ69631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty