Individual
DR. BRIAN W. HAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
410 LAKEBRIDGE PLAZA DR, ORMOND BEACH, FL 32174-5157
(386) 672-3988
(386) 672-2663
Mailing address
410 LAKEBRIDGE PLAZA DR, ORMOND BEACH, FL 32174-5157
(386) 672-3988
(386) 672-2663
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN12711
FL
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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