Alan D. Hathaway D.D.S. P.C.
Organization Active NPI Dentist · Davenport, IA
NPI 1003949447 · NPPES record last updated Jun 12, 2008
Key facts
- NPI
- 1003949447
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 4555 (IA)
- Legal business name
- ALAN D. HATHAWAY D.D.S. P.C.
- Practice address
- 1333 W Lombard St
Davenport, IA 52804 - Phone
- (563) 322-1451
- Fax
- (563) 323-3688
- NPI assigned
- Mar 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Alan D. Hathaway, D.D.S.
- Title
- Dentist
- Phone
- (563) 322-1451
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 4555 | IA | Yes |
Addresses
Primary practice location
1333 W Lombard St
Davenport, IA 52804
Mailing address
1333 W Lombard St
Davenport, IA 52804
Phone (563) 322-1451
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0048132 | Medicaid | IA |
Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.