Healthcare Provider Details

I. General information

NPI: 1811434970
Provider Name (Legal Business Name): MARINA HAGENS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2017
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 PINCKNEY COLONY RD BLDG 500 SUITE 503 HOWARD FAMILY DENTAL
BLUFFTON SC
29909
US

IV. Provider business mailing address

PINCKNEY COLONY RD BLDG 500 SUITE 503
BLUFFTON SC
29910
US

V. Phone/Fax

Practice location:
  • Phone: 843-593-9380
  • Fax:
Mailing address:
  • Phone: 843-864-4536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN015342
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: