Provider Demographics
NPI:1124746730
Name:HAHN, OLGA LUCIA (52 DMD)
Entity type:Individual
Prefix:DR
First Name:OLGA
Middle Name:LUCIA
Last Name:HAHN
Suffix:
Gender:F
Credentials:52 DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5001 HIGHWAY 165
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29449-6108
Mailing Address - Country:US
Mailing Address - Phone:843-693-3947
Mailing Address - Fax:
Practice Address - Street 1:173 ASHLEY AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8908
Practice Address - Country:US
Practice Address - Phone:843-876-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC52122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty