Paul Ivan Hathorn, D.M.D.

NPI #1225130040 in Ellisville, Mississippi

Provider Information

NPI Number: 1225130040
Entity Type: Individual
Name: Paul Ivan Hathorn, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Sep 2, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1101 HIGHWAY 11 S
City: Ellisville
State: Mississippi
ZIP Code: 39437-4443
Phone: (601) 477-5792

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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Organizations

Provider Name	Specialty	City
Ellisville State School Dental	Dentist	Ellisville	AI Deep Dive

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