Individual
DR. GREG DANIEL HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
616 FIFTH STREET, AMES, IA 50010-0848
(515) 232-5401
(515) 233-1804
Mailing address
PO BOX 848, 616 FIFTH STREET, AMES, IA 50010-0848
(515) 232-5401
(515) 233-1804
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8109
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0239897
—
IA
Enumeration date
01/17/2007
Last updated
07/08/2007
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