Provider Demographics
NPI:1295220341
Name:HATAMPA, CHARITY H (DDS)
Entity type:Individual
Prefix:DR
First Name:CHARITY
Middle Name:H
Last Name:HATAMPA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 SOUTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284
Mailing Address - Country:US
Mailing Address - Phone:336-967-0955
Mailing Address - Fax:336-967-0951
Practice Address - Street 1:950 SOUTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284
Practice Address - Country:US
Practice Address - Phone:336-967-0955
Practice Address - Fax:336-967-0951
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-29
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC111251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice