Individual
JESSICA HATALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
750 ROUTE 739, LORDS VALLEY, PA 18428-6058
(570) 775-7818
Mailing address
1239 DUNDAFF ST, DICKSON CITY, PA 18519-1142
(570) 604-2611
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS042331
PA
Other
Enumeration date
06/09/2020
Last updated
07/20/2020
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