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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