| Hatfield Dental Clinic Pc | |
|
220 W. Guadalupe St. La Grange TX 78945-1926 | |
| (979) 208-8638 | |
| (979) 272-4563 |
| Full Name | Hatfield Dental Clinic Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 220 W. Guadalupe St., La Grange, Texas |
| Authorized Official Name and Position | Lawrence J Hatfield (PRESIDENT) |
| Authorized Official Contact | 9792088638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hatfield Dental Clinic Pc 220 W Guadalupe St La Grange TX 78945-1926 Ph: (979) 208-8638 | Hatfield Dental Clinic Pc 220 W. Guadalupe St. La Grange TX 78945-1926 Ph: (979) 208-8638 |
| NPI Number | 1568956589 |
|---|---|
| Provider Enumeration Date | 06/22/2018 |
| Last Update Date | 08/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568956589 | NPI | - | NPPES |
| 1649351875 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 13463 (Texas) | Primary |
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