Individual
MATTHEW ALEX HACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2140 FAIRVIEW BLVD, FAIRVIEW, TN 37062-9065
(615) 799-9964
(615) 799-9981
Mailing address
2140 FAIRVIEW BLVD, FAIRVIEW, TN 37062-9065
(615) 799-9964
(615) 799-9981
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10525
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10525
TN PROFESSIONAL LICENSE NUMBER
TN
Enumeration date
06/19/2017
Last updated
07/21/2022
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