Organization
HAZELTON FAMILY DENTISTRY, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZACHARY DAVID HAZELTON D.D.S. (DENTIST)
(218) 333-8668
Entity
Organization
Contact information
Practice address
677 ANNE ST NW, STE F, BEMIDJI, MN 56601-4390
(218) 333-8668
Mailing address
PO BOX 397, BEMIDJI, MN 56619-0397
(218) 333-8668
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D12566
MN
Other
Enumeration date
06/12/2008
Last updated
06/12/2008
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