Jeremy D Hatch, DMD

Individual provider Active NPI General Practice Dentistry · Hurricane, UT

NPI 1861529612 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1861529612
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5657631-9922 (UT)
Practice address
52 South 850 West
Suite 201
Hurricane, UT 84737
Phone
(435) 635-9471
Fax
(435) 635-9473
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5657631-9922UTMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5657631-9922 UT Yes

Addresses

Primary practice location

52 South 850 West
Suite 201
Hurricane, UT 84737

Mailing address

52 South 850 West
Suite 201
Hurricane, UT 84737
Phone (435) 635-9471

Other providers in Hurricane, UT

All providers in Hurricane, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.