Organization
EARL B HARTZOG DMD PA
Active
Parent organization
EARL B HARTZOG DMD PA
Other names
St Matthews Dentistry
Organization subpart
Yes
Provider details
NPI number
Legal business name
EARL B HARTZOG DMD PA
Authorized official
DR. EARL B HARTZOG DMD (OWNER)
(843) 560-1543
Entity
Organization
Contact information
Practice address
735 HARRY C RAYSOR DR, ST MATTHEWS, SC 29135-8403
(803) 874-2243
Mailing address
735 HARRY C RAYSOR DR, ST MATTHEWS, SC 29135-8403
(803) 874-2243
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4591
SC
Other
Enumeration date
03/29/2017
Last updated
06/25/2019
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