| Terry H Hake Dds Pc | |
|
1761 Jamestown Road Suite 102 Williamsburg VA 23185 | |
| (757) 229-4115 | |
| (757) 229-8297 |
| Full Name | Terry H Hake Dds Pc |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 1761 Jamestown Road, Williamsburg, Virginia |
| Authorized Official Name and Position | Terry Henry Hake (OWNER ENDODONTIST) |
| Authorized Official Contact | 7572294115 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Terry H Hake Dds Pc 1761 Jamestown Road Suite 102 Williamsburg VA 23185 Ph: (757) 229-4115 | Terry H Hake Dds Pc 1761 Jamestown Road Suite 102 Williamsburg VA 23185 Ph: (757) 229-4115 |
| NPI Number | 1104017060 |
|---|---|
| Provider Enumeration Date | 08/06/2007 |
| Last Update Date | 08/06/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104017060 | NPI | - | NPPES |
| 234929 | Other | ANTHEM | |
| 166891 | Other | UNITED CONCORDIA | |
| 10153 | Medicaid | VA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 0401008049 (Virginia) | Primary |
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