Provider Demographics
NPI:1881790376
Name:HATCHER, TYRUS NEAPOLIS (DDS)
Entity type:Individual
Prefix:DR
First Name:TYRUS
Middle Name:NEAPOLIS
Last Name:HATCHER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 68TH STREET
Mailing Address - Street 2:FORT HOOD DENTAL ACTIVITY CREDENTIALS OFFICE
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-287-2705
Mailing Address - Fax:254-287-1786
Practice Address - Street 1:4431 68TH STREET
Practice Address - Street 2:FORT HOOD DENTAL ACTIVITY CREDENTIALS OFFICE
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-287-2705
Practice Address - Fax:254-287-1786
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00201191223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry