Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | DEN-10665 | CO |
N | 1223G0001X | General Practice | 8013484-9922 | UT |
N | 213EG0000X | General Practice | 8013484-9922 | UT |
NPI | 1003103789 |
---|---|
Provider Name | Dr. Daniel Hatch |
First Address | Montrose, CO 81401-4043 |
Second Address | Montrose, CO 81401-4043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 11/03/2012 |