Individual
JOHN PANNILL HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
903C MEDICAL CENTRE DR, ARLINGTON, TX 76012
(817) 461-9494
(817) 860-1608
Mailing address
903C MEDICAL CENTRE DR, ARLINGTON, TX 76012
(817) 461-9494
(817) 860-1608
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
9790
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00BH69
BLUE CROSS BLUE SHIELD
—
01
—
4661637
UNITED CONCORDIA
—
Enumeration date
11/16/2006
Last updated
07/08/2007
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