| Anthony J Hathaway Dds Pc | |
|
1333 W Lombard St Davenport IA 52804-2101 | |
| (563) 323-9331 | |
| Not Available |
| Full Name | Anthony J Hathaway Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1333 W Lombard St, Davenport, Iowa |
| Authorized Official Name and Position | Anthony J Hathaway (OWNER) |
| Authorized Official Contact | 5633239331 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Anthony J Hathaway Dds Pc 1333 W Lombard St Davenport IA 52804-2101 Ph: (563) 323-9331 | Anthony J Hathaway Dds Pc 1333 W Lombard St Davenport IA 52804-2101 Ph: (563) 323-9331 |
| NPI Number | 1013092667 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013092667 | NPI | - | NPPES |
| 1057968 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 07404 (Iowa) | Primary |
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