Provider Demographics
NPI:1831361872
Name:HATZIS, LOUIS IOANNIS (DOCTOR OF DENTAL SUR)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:IOANNIS
Last Name:HATZIS
Suffix:
Gender:M
Credentials:DOCTOR OF DENTAL SUR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36800 RYAN
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310
Mailing Address - Country:US
Mailing Address - Phone:586-264-2000
Mailing Address - Fax:586-264-2293
Practice Address - Street 1:36800 RYAN
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310
Practice Address - Country:US
Practice Address - Phone:586-264-2000
Practice Address - Fax:586-264-2293
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI134661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice