Individual
DEAN H HATTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
80 B VETERANS BLVD, I-40, EXIT 102, ACOMA, NM 87034
(505) 552-5300
(505) 552-5811
Mailing address
PO BOX 130, SAN FIDEL, NM 87049-0130
(505) 552-5300
(505) 552-5811
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
001231
WA
152W00000X
Optometrist
Primary
2106
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3450
—
NM
Enumeration date
03/15/2006
Last updated
08/01/2016
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