Provider Demographics
NPI:1841307055
Name:HAZLETT, JAMES CUMMINS III (DDS)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CUMMINS
Last Name:HAZLETT
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3900 CLARK RD
Mailing Address - Street 2:E3
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34233
Mailing Address - Country:US
Mailing Address - Phone:941-922-0671
Mailing Address - Fax:941-924-0579
Practice Address - Street 1:3900 CLARK RD
Practice Address - Street 2:E3
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233
Practice Address - Country:US
Practice Address - Phone:941-922-0671
Practice Address - Fax:941-924-0579
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN15028122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist