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General NPI Number Information
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NPI Number | 1265501654
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Entity Type | Organization
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Legal Business Name | BURTON L HAGLER DDS INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1202 NORTH MONROE DRIVE
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City | XENIA
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State | OH
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Zip | 45385-1622
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Country | US
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Telephone | 937-372-9279
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Fax | 937-374-0334
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Provider Business Mailing Address
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Address Line | 1202 NORTH MONROE DRIVE
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City | XENIA
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State | OH
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Zip | 45385-1622
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Country | US
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Telephone | 937-372-9279
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Fax | 937-374-0334
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Authorized Official
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Title or Position | DR OWNER
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Name | DR. BURTON LOUIS HAGLER
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Credential | DDS MS
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Telephone | 937-372-9279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 19712
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License Number State | OH
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