Organization
EARL B HARTZOG DMD PA
Active
Other names
Bamberg Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARL BARRETT HARTZOG DMD (PRESIDENT)
(803) 245-5545
Entity
Organization
Contact information
Practice address
474 NORTH ST, BAMBERG, SC 29003-1318
(803) 245-5545
(803) 245-5534
Mailing address
474 NORTH ST, BAMBERG, SC 29003-1318
(803) 245-5545
(803) 245-5534
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4591
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZX4591
—
SC
Enumeration date
10/14/2011
Last updated
10/14/2011
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