Provider Demographics
NPI:1932977147
Name:CHARITY H HATAMPA DDS PLLC
Entity Type:Organization
Organization Name:CHARITY H HATAMPA DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:H
Authorized Official - Last Name:HATAMPA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-967-0955
Mailing Address - Street 1:950 S. MAIN ST.
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 S MAIN ST
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty