Provider Demographics
NPI:1265501654
Name:BURTON L HAGLER DDS INC
Entity Type:Organization
Organization Name:BURTON L HAGLER DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BURTON
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:HAGLER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:937-372-9279
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH197121223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty