Individual
DR. BREA FAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
8730 CHERRY LN, LAUREL, MD 20707-6212
(410) 251-4932
Mailing address
6006 GRENFELL LOOP, BOWIE, MD 20720-5343
(410) 251-4932
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
18058
MD
Other
Enumeration date
04/06/2023
Last updated
08/07/2024
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