Provider Demographics
NPI:1053611590
Name:HATTON, DAVID JAY (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAY
Last Name:HATTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 221979
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923
Mailing Address - Country:US
Mailing Address - Phone:831-624-7950
Mailing Address - Fax:831-625-2681
Practice Address - Street 1:26365 CARMEL RANCHO BLVD.
Practice Address - Street 2:SUITE A
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923
Practice Address - Country:US
Practice Address - Phone:831-624-7950
Practice Address - Fax:831-625-2681
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA240261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice