Provider Demographics
NPI:1851377873
Name:HARTLEY, GEORGE WESTLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WESTLEY
Last Name:HARTLEY
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 1:8501 TANNER WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-8322
Mailing Address - Country:US
Mailing Address - Phone:251-441-6405
Mailing Address - Fax:251-441-6415
Practice Address - Street 1:8501 TANNER WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-8322
Practice Address - Country:US
Practice Address - Phone:251-441-6405
Practice Address - Fax:251-441-6415
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00119051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice