Provider Demographics
NPI:1659806305
Name:BRIAN HATCH, D.D.S., P.A.
Entity Type:Organization
Organization Name:BRIAN HATCH, D.D.S., P.A.
Other - Org Name:ALL ABOUT SMILES
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:888-825-4214
Mailing Address - Street 1:118 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PIPESTONE
Mailing Address - State:MN
Mailing Address - Zip Code:56164-1652
Mailing Address - Country:US
Mailing Address - Phone:888-825-4214
Mailing Address - Fax:507-825-4216
Practice Address - Street 1:118 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PIPESTONE
Practice Address - State:MN
Practice Address - Zip Code:56164-1652
Practice Address - Country:US
Practice Address - Phone:888-825-4214
Practice Address - Fax:507-825-4216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13392261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental