Individual
DR. CARL JOHN HASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
413 N 17TH AVE, WAUSAU, WI 54401-4226
(715) 842-4649
(715) 842-7331
Mailing address
413 N 17TH AVE, WAUSAU, WI 54401-4226
(715) 842-4649
(715) 842-7331
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
5001555
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310953001
BCBS ID#
WA
05
—
33539900
—
WA
01
—
5001555
DELTA WI ID#
WI
Enumeration date
04/17/2007
Last updated
07/09/2007
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