Provider Demographics
NPI:1780603068
Name:HAHN, PHILIP LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:LOUIS
Last Name:HAHN
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 1:16049 JOHNSTON RD STE I
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-2605
Mailing Address - Country:US
Mailing Address - Phone:704-705-1408
Mailing Address - Fax:
Practice Address - Street 1:16049 JOHNSTON RD STE I
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28277-2605
Practice Address - Country:US
Practice Address - Phone:704-705-1408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8534122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist