| NPI | 1215016548 |
|---|---|
| Former Legal Business Name | EVAN W HATHAWAY DDS |
| Entity Type | Organization |
| Authorized Contact | EVAN WAYNE HATHAWAY President 208-377-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ID D2040) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |