Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. EVAN HATHAWAY, DDS
Active Sole ProprietorDR. EVAN HATHAWAY, DDS is a Dentist healthcare provider located in EAGLE, Idaho. NPI 1033455019 is currently active in the NPPES registry. Verify at CMS.
Dentist · EAGLE, ID
Registration Details
- NPI Number
- 1033455019
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 20, 2012 (13.605992369741 yrs)
- Last Updated
- Dec 20, 2012
- License
-
D2040 (ID)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1217 E IRON EAGLE DREAGLE, ID, 836166599Browse ID providers · Browse ZIP 83616
- Phone
- 2083771161
- Fax
- 2089380567
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in EAGLE, ID
| Name | Credential | NPI |
|---|---|---|
| DR. GREG RON DAVIS | D.D.S | 1699960039 |
| CALEB EDWARD STOTT | DMD | 1962882548 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.