Provider Demographics
NPI:1780707463
Name:HATCH, HYRUM GREGORY (DDS)
Entity type:Individual
Prefix:DR
First Name:HYRUM
Middle Name:GREGORY
Last Name:HATCH
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 1:7350 S MCCLINTOCK DR
Mailing Address - Street 2:# 103
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5006
Mailing Address - Country:US
Mailing Address - Phone:480-838-3073
Mailing Address - Fax:480-838-5504
Practice Address - Street 1:7350 S MCCLINTOCK DR
Practice Address - Street 2:# 103
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5006
Practice Address - Country:US
Practice Address - Phone:480-838-3073
Practice Address - Fax:480-838-5504
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3704122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist