Provider Demographics
NPI:1063602175
Name:HAGLER, BURTON LOUIS (DDS MS)
Entity type:Individual
Prefix:MR
First Name:BURTON
Middle Name:LOUIS
Last Name:HAGLER
Suffix:
Gender:M
Credentials:DDS MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1202 NORTH MONROE DRIVE
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-1622
Mailing Address - Country:US
Mailing Address - Phone:937-372-9279
Mailing Address - Fax:937-374-0334
Practice Address - Street 1:1202 NORTH MONROE DRIVE
Practice Address - Street 2:
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385-1622
Practice Address - Country:US
Practice Address - Phone:937-372-9279
Practice Address - Fax:937-374-0334
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH197121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics