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Organization
SURFSIDE KIDS PEDIATRIC DENTISTRY P.C.
Active
Organization
SURFSIDE KIDS PEDIATRIC DENTISTRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOY HAGAN DDS (PEDIATRIC DENTIST)
(912) 272-7656
Entity
Organization
Contact information
Practice address
256 SCRANTON CONNECTOR, STE 110, BRUNSWICK, GA 31525-0556
(912) 272-7656
Mailing address
256 SCRANTON CONNECTOR, STE 110, BRUNSWICK, GA 31525-0556
(912) 272-7656
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DN015083
GA
Other
Enumeration date
05/11/2016
Last updated
05/11/2016
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