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1033455019
EVAN HATHAWAY
EAGLE, ID
NPI
1033455019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: ID D2040)
Enumeration Date
2012-12-20
Last Update Date
2012-12-20
Business Address
Dr. EVAN HATHAWAY DDS
1217 E IRON EAGLE DR
EAGLE, ID 83616-6599
Phone number: 208-377-1161
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Mailing Address
Dr. EVAN HATHAWAY DDS
1217 E IRON EAGLE DR
EAGLE, ID 83616-6599
Phone number: 208-377-1161
Copy
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