Provider Demographics
NPI:1528302841
Name:RICK HOAGLIN DMD PC
Entity type:Organization
Organization Name:RICK HOAGLIN DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HOAGLIN
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:406-728-0200
Mailing Address - Street 1:3815 STEPHENS AVE
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8505
Mailing Address - Country:US
Mailing Address - Phone:406-728-0200
Mailing Address - Fax:406-728-0201
Practice Address - Street 1:3815 STEPHENS AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8505
Practice Address - Country:US
Practice Address - Phone:406-728-0200
Practice Address - Fax:406-728-0201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT20641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty