Provider Demographics
NPI:1982803110
Name:HATFIELD, MARCUS CRAIG (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:CRAIG
Last Name:HATFIELD
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 1:705 MORGANTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-4331
Mailing Address - Country:US
Mailing Address - Phone:304-366-0088
Mailing Address - Fax:304-366-1223
Practice Address - Street 1:705 MORGANTOWN AVE
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-4331
Practice Address - Country:US
Practice Address - Phone:304-366-0088
Practice Address - Fax:304-366-1223
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV37061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice