Individual
BRIAN JEFFREY HOAGBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
9409 ILLINOIS RD, FORT WAYNE, IN 46804-5795
(260) 486-4400
Mailing address
9409 ILLINOIS RD, FORT WAYNE, IN 46804-5795
(260) 486-4400
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12013167A
IN
Other
Enumeration date
07/28/2020
Last updated
10/23/2023
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