| Hatala Orthodontics Pc | |
|
165 Riversidedrive Johnson City NY 13790 | |
| (607) 644-9100 | |
| (607) 644-9113 |
| Full Name | Hatala Orthodontics Pc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 165 Riversidedrive, Johnson City, New York |
| Authorized Official Name and Position | Mark P Hatala (PRES) |
| Authorized Official Contact | 6076449100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hatala Orthodontics Pc 165 Riverside Drive Johnson City NY 13790 Ph: (607) 644-9100 | Hatala Orthodontics Pc 165 Riversidedrive Johnson City NY 13790 Ph: (607) 644-9100 |
| NPI Number | 1295812782 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295812782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 041662 (New York) | Primary |
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