Thomas I Hazelton, DDS
Individual provider Active NPI General Practice Dentistry · Deckerville, MI
NPI 1306067400 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1306067400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 14209 (MI)
- Practice address
- 2382 Black River St
Deckerville, MI 48427 - Phone
- (810) 376-2395
- Fax
- (810) 376-2305
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14209 | MI | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 14209 | MI | Yes |
Addresses
Primary practice location
2382 Black River St
Deckerville, MI 48427
Mailing address
PO Box 460
2382 Black River St
Deckerville, MI 48427
Phone (810) 376-2395
Other providers in Deckerville, MI
- Deckerville Nursing Center, LLC
- Pany Decossard
- Carrie V Eugster
- For the Family Counseling Service PLLC
- Levi L Guerrero
- Judith Ann Kaszyca
- Levi L. Guerrero, MD, PC
- Aram J Makkinejad
- Malorie McVittie
- Nicole Miller
All providers in Deckerville, MI · General Practice Dentistry in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.