Individual
DR. DENNIS SCOTT HATCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1177 PARKWAY DR, BLACKFOOT, ID 83221-1652
(208) 785-1360
(208) 782-0105
Mailing address
1177 PARKWAY DR, BLACKFOOT, ID 83221-1652
(208) 785-1360
(208) 782-0105
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D3226
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010010275
BLUE SHIELD OF IDAHO
ID
01
—
6A770
BLUE CROSS OF IDAHO
ID
01
—
787392
UNITED CONCORDIA
ID
01
—
ID03226
DELTA DENTAL
ID
Enumeration date
08/30/2006
Last updated
07/09/2007
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