Provider Demographics
NPI:1124130422
Name:HADNOT, DOUGLAS STANLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:STANLEY
Last Name:HADNOT
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:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:LOLO
Mailing Address - State:MT
Mailing Address - Zip Code:59847-0278
Mailing Address - Country:US
Mailing Address - Phone:406-273-6979
Mailing Address - Fax:406-273-6979
Practice Address - Street 1:3159 HWY 83
Practice Address - Street 2:
Practice Address - City:SEELEY LAKE
Practice Address - State:MT
Practice Address - Zip Code:59868-0718
Practice Address - Country:US
Practice Address - Phone:406-677-2235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT13481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice