Earl B Hartzog Dmd PA

NPI #1114202736 in Bamberg, South Carolina

Provider Information

NPI Number: 1114202736
Entity Type: Organization
Organization Name: Earl B Hartzog Dmd PA
Primary Specialty: Dentist
Enumeration Date: Oct 14, 2011
Last Updated: Oct 14, 2011

Practice Location

Address: 474 NORTH ST
City: Bamberg
State: South Carolina
ZIP Code: 29003-1318
Phone: (803) 245-5545

Authorized Official

Name: DR. EARL BARRETT HARTZOG, DMD
Title: PRESIDENT
Phone: (803) 245-5545

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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