Randy S Hathorn, DMD

NPI #1912018748 in Bassfield, Mississippi

Provider Information

NPI Number: 1912018748
Entity Type: Individual
Name: Randy S Hathorn, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DMD
Enumeration Date: Aug 31, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 218 A GEN ROBERT E BLOUNT DR
City: Bassfield
State: Mississippi
ZIP Code: 39421-0549
Phone: (601) 943-5426

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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