Provider Demographics
NPI:1699925859
Name:HAWN, KIRK G (DDS)
Entity type:Individual
Prefix:
First Name:KIRK
Middle Name:G
Last Name:HAWN
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 319
Mailing Address - Street 2:
Mailing Address - City:LOVETTSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20180
Mailing Address - Country:US
Mailing Address - Phone:540-822-5446
Mailing Address - Fax:540-822-9333
Practice Address - Street 1:21 E. BROADWAY ST
Practice Address - Street 2:
Practice Address - City:LOVETTSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20180
Practice Address - Country:US
Practice Address - Phone:540-822-5446
Practice Address - Fax:540-822-9333
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401006795122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist