NPI Search for Physicians and Health Care Providers
C. EDWARD HAGAN D.D.S.
General Practice >> Dentist >> Dental ProvidersRegistrant NPI Number: 1306853718
Individual Registrant:
C. EDWARD HAGAN D.D.S.
Gender: M
Sole Proprietor
Location and contact information for practice:
112 CLIFFORD AVE SYLVANIA, GA 30467-2012 US
Tel: 912-564-7107 Fax: 912-564-9349
Contact information for business:
114 MORNINGSIDE DR SYLVANIA, GA 30467-8515 US
Tel: 912-564-2173 Fax: --
Registration Information:
NPI: 1306853718
Entity Type: Individual
Specialty information:
Primary | Code | Category/Description | State | License Number |
---|
Y | 1223G0001X | Dental Providers Dentist General Practice | GA | 7053 |
Legacy codes, insurance codes and state license numbers:
Issuer | Number | State | Type |
---|
| 00046373A | GA | 05 |
HEALTH CARE JOBS GA - Page 1