SURFSIDE KIDS PEDIATRIC DENTISTRY P.C.


Address: 256 Scranton Connector, Ste 110, Brunswick, GA 31525-0556
Phone: 9122727656

SURFSIDE KIDS PEDIATRIC DENTISTRY P.C. (NPI# 1144676826) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144676826
Entity Type Organization
Organization Name SURFSIDE KIDS PEDIATRIC DENTISTRY P.C.
Practice Address 256 Scranton Connector
Ste 110
Brunswick
GA 31525-0556
Practice Telephone 9122727656
Mailing Telephone 9122727656
Enumeration Date 2016-05-11
Last Update Date 2016-05-11
Authorized Official Name DR. LOY HAGAN (PEDIATRIC DENTIST)
Authorized Official Telephone 9122727656
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QD0000X Clinic/Center
Specialization: Dental
DN015083 GA Ambulatory Health Care Facilities

Office Location

Street Address 256 SCRANTON CONNECTOR
STE 110
City BRUNSWICK
State GA
Zip Code 31525-0556

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Taxonomy Information

Taxonomy Code 261QD0000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Dental

Taxonomy Definition

Definition to come...

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1386866986 Brunswick Family Dental Practice Inc Clinic/Center 3487 Center Road, Suite 8, Brunswick, OH 44212 2007-05-03
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Competitor

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City BRUNSWICK
Zip Code 31525

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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