Individual
MICHAEL J HACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
51565 BITTERSWEET RD, GRANGER, IN 46530-8859
(574) 277-1211
(574) 277-5812
Mailing address
51565 BITTERSWEET RD, GRANGER, IN 46530-8859
(574) 277-1211
(574) 277-5812
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12012903A
IN
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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