Provider Demographics
NPI:1922117746
Name:KIRK G HAWN DDS PC INC
Entity Type:Organization
Organization Name:KIRK G HAWN DDS PC INC
Other - Org Name:KIRK G HAWN DDS KIRK G HAWN DDS FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRK
Authorized Official - Middle Name:GUY
Authorized Official - Last Name:HAWN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-822-5446
Mailing Address - Street 1:PO BOX 319
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180-0319
Mailing Address - Country:US
Mailing Address - Phone:540-822-5446
Mailing Address - Fax:540-822-9333
Practice Address - Street 1:21 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180-0319
Practice Address - Country:US
Practice Address - Phone:540-822-5446
Practice Address - Fax:540-822-9333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006795122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty