Provider Demographics
NPI:1700017738
Name:HAST, WILLIAM F (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:F
Last Name:HAST
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 TALON TRL
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-6312
Mailing Address - Country:US
Mailing Address - Phone:606-878-7428
Mailing Address - Fax:
Practice Address - Street 1:1019 CUMBERLAND FALLS HWY STE D141
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-2796
Practice Address - Country:US
Practice Address - Phone:606-528-5527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY54981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60054988Medicaid