Organization
SOUL SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT HATHAWAY (OWNER/DENTIST)
(301) 523-0939
Entity
Organization
Contact information
Practice address
5402 QUEENS CHAPEL RD, HYATTSVILLE, MD 20782-3901
(240) 696-7842
Mailing address
10932 HILLTOP LN, COLUMBIA, MD 21044-3780
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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