Organization
EVAN HATHAWAY DDS PA
Active
Other names
Evan W Hathaway DDS
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN WAYNE HATHAWAY DDS (PRESIDENT)
(208) 377-1161
Entity
Organization
Contact information
Practice address
7677 EMERALD ST, BOISE, ID 83704
(208) 377-1161
(208) 376-3979
Mailing address
7677 EMERALD ST, BOISE, ID 83704
(208) 377-1161
(208) 376-3979
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D2040
ID
Other
Enumeration date
11/06/2006
Last updated
08/22/2020
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