Provider Demographics
NPI:1922136837
Name:HATTEN, JOHN H II (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:HATTEN
Suffix:II
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 1:603 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-4528
Mailing Address - Country:US
Mailing Address - Phone:432-332-8300
Mailing Address - Fax:432-332-8301
Practice Address - Street 1:603 E 6TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-4528
Practice Address - Country:US
Practice Address - Phone:432-332-8300
Practice Address - Fax:432-332-8301
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX136281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice