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Individual

ALESIA HATTEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
6958 NEBRASKA AVE, FORT LEONARD WOOD, MO 65473-1618
(573) 596-0411
(573) 596-0410
Mailing address
24180 TANGLEWOOD RD, SAINT ROBERT, MO 65584-3815
(601) 212-5375
(601) 212-5375

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2014018760
MO
122300000X
Dentist
9874
TN

Other

Enumeration date
08/04/2014
Last updated
08/04/2014
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