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Individual
JUSTIN HASTINGS
Active
Individual
JUSTIN HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MD
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
D-4845OS
ID
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
M-13732
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104248053
—
ID
Enumeration date
02/28/2011
Last updated
04/16/2018
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