Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 5325919-9921 | UT |
N | 122300000X | Dentist | 5595 | NV |
N | 122300000X | Dentist | DE00009800 | WA |
Y | 1223E0200X | Endodontist | DE00009800 | WA |
NPI | 1104804186 |
---|---|
Provider Name | Dr. Garth William Hatch |
First Address | Kennewick, WA 99336-6710 |
Second Address | Kennewick, WA 99336-6710 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2006 |
Last Update Date | 21/06/2010 |