Provider Demographics
NPI:1235289141
Name:HATCH, HARRY WILLIAM (DDS)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:WILLIAM
Last Name:HATCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W LEON ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32347-2636
Mailing Address - Country:US
Mailing Address - Phone:850-584-3118
Mailing Address - Fax:
Practice Address - Street 1:8501 HAMPTON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:FL
Practice Address - Zip Code:32348-8747
Practice Address - Country:US
Practice Address - Phone:850-838-4189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0009622122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist