| Evan Hathaway Dds Pa | |
|
1217 E Iron Eagle Dr Eagle ID 83616 | |
| (208) 377-1161 | |
| (208) 938-0567 |
| Full Name | Evan Hathaway Dds Pa |
|---|---|
| Speciality | Dentist |
| Location | 1217 E Iron Eagle Dr, Eagle, Idaho |
| Authorized Official Name and Position | Evan Wayne Hathaway (OWNER PRES CORPORATION) |
| Authorized Official Contact | 2083789704 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evan Hathaway Dds Pa 1217 E Iron Eagle Dr Eagle ID 83616 Ph: (208) 377-1161 | Evan Hathaway Dds Pa 1217 E Iron Eagle Dr Eagle ID 83616 Ph: (208) 377-1161 |
| NPI Number | 1851552194 |
|---|---|
| Provider Enumeration Date | 06/19/2008 |
| Last Update Date | 06/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851552194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D2040 (Idaho) | Primary |
Lighthouse Dental Group Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1177 N Eagle Rd, Eagle, ID 83616 Phone: 208-939-3010 Fax: 208-939-3027 | |
Donald E Larson Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 700 E State St, Suite 100, Eagle, ID 83616 Phone: 208-939-3500 Fax: 208-939-3837 | |
Eagle Dental Partnership Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 577 E State St, Eagle, ID 83616 Phone: 208-342-4644 | |
Premier Dentistry Of Eagle Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 467 S Rivershore Ln, Eagle, ID 83616 Phone: 208-938-1247 | |
Eagle Oral Surgery And Dental Implant Center Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 197 W State St, Eagle, ID 83616 Phone: 208-995-2865 | |
Hathaway And Pelletier Family Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1217 E Iron Eagle Dr, Eagle, ID 83616 Phone: 208-377-1161 Fax: 208-938-0567 |