Individual
DR. DUSTIN C HEDGPETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.S.D.
Contact information
Practice address
107 GRAND CENTRAL BLVD, SUITE 206, POOLER, GA 31322-4147
(912) 988-1907
(912) 988-7689
Mailing address
107 GRAND CENTRAL BLVD, SUITE 206, POOLER, GA 31322-4147
(912) 988-1907
(912) 988-7689
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
3540-10
MS
1223P0300X
Periodontics
Primary
DN014619
GA
Other
Enumeration date
08/23/2012
Last updated
10/23/2014
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