| Alan D. Hathaway D.d.s. P.c. | |
|
1333 W Lombard St Davenport IA 52804 | |
| (563) 322-1451 | |
| (563) 323-3688 |
| Full Name | Alan D. Hathaway D.d.s. P.c. |
|---|---|
| Speciality | Dentist |
| Location | 1333 W Lombard St, Davenport, Iowa |
| Authorized Official Name and Position | Alan D. Hathaway (DENTIST) |
| Authorized Official Contact | 5633221451 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alan D. Hathaway D.d.s. P.c. 1333 W Lombard St Davenport IA 52804 Ph: (563) 322-1451 | Alan D. Hathaway D.d.s. P.c. 1333 W Lombard St Davenport IA 52804 Ph: (563) 322-1451 |
| NPI Number | 1003949447 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 06/12/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003949447 | NPI | - | NPPES |
| 0048132 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4555 (Iowa) | Primary |
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