Provider Demographics
NPI:1851968747
Name:CARRIE E. HAZEY, DDS, INC.
Entity Type:Organization
Organization Name:CARRIE E. HAZEY, DDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:HAZEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:304-622-0595
Mailing Address - Street 1:720 E PIKE ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26301-2240
Mailing Address - Country:US
Mailing Address - Phone:304-622-0595
Mailing Address - Fax:304-622-6290
Practice Address - Street 1:720 E PIKE ST
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-2240
Practice Address - Country:US
Practice Address - Phone:304-622-0595
Practice Address - Fax:304-622-6290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty