Individual
CARL F HACKNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
RIVERSIDE DRIVE, GRUNDY, VI 24614-2814
(276) 935-4565
(276) 935-8545
Mailing address
PO BOX 2814, RIVERSIDE DRIVE, GRUNDY, VI 24614-2814
(276) 935-4565
(276) 935-8545
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401008666
VA
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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