Individual
MARK P HATALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
165 RIVERSIDE DRIVE, JOHNSON CITY, NY 13790
(607) 644-9100
(607) 644-9113
Mailing address
165 RIVERSIDE DRIVE, JOHNSON CITY, NY 13790
(607) 644-9100
(607) 644-9113
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
041662
NY
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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