Individual
GEORGE FRED HAZELWOOD III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
736 E OAK ST, OAKLAND, MD 21550-1615
(301) 334-9288
(301) 334-5471
Mailing address
736 E OAK ST, OAKLAND, MD 21550-1615
(301) 334-9288
(301) 334-5471
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
MD8301
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
296936
MAMSI
—
01
—
3264
BLUE CROSS BLUE SHIELD
—
01
—
34571
UNITED HEALTH CARE
—
01
—
850897
UNITED CONCORDIA
—
01
—
D103088
CIGNA
—
Enumeration date
09/05/2006
Last updated
07/08/2007
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