Provider Demographics
NPI:1790555423
Name:HATTEN, RANEY (RDH)
Entity Type:Individual
Prefix:
First Name:RANEY
Middle Name:
Last Name:HATTEN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-7697
Mailing Address - Country:US
Mailing Address - Phone:406-371-1958
Mailing Address - Fax:
Practice Address - Street 1:820 SAMPSON ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-3208
Practice Address - Country:US
Practice Address - Phone:406-565-4458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTDEN-RDH-LIC-17444124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist