Provider Demographics
NPI:1952532251
Name:HAWKINS, DIANE N (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:N
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HQS, USA DENTAC
Mailing Address - Street 2:4431 68TH STREET
Mailing Address - City:FT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5054
Mailing Address - Country:US
Mailing Address - Phone:254-287-2705
Mailing Address - Fax:254-287-2705
Practice Address - Street 1:HQS, USA DENTAC
Practice Address - Street 2:4431 68TH STREET
Practice Address - City:FT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544-5054
Practice Address - Country:US
Practice Address - Phone:254-287-2705
Practice Address - Fax:254-287-2705
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-04
Last Update Date:2009-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24686122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist