Individual
FANTA HAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
36014 WRATTEN AVE., FT. HOOD, TX 76544
(254) 286-7401
Mailing address
36014 WRATTEN AVE., FT. HOOD, TX 76544
(254) 286-7401
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
TX
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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