Individual
DR. HAGEN V. HASTINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
220 BARTON BLVD, UNIT C14, ROCKLEDGE, FL 32955-2742
(321) 639-5177
(321) 639-4927
Mailing address
PO BOX 1137, MELBOURNE, FL 32902-1137
(321) 952-9696
(321) 952-7937
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN19142
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003173400
—
FL
Enumeration date
06/30/2010
Last updated
11/26/2012
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