Provider Demographics
NPI:1639205404
Name:HOAGLIN, GEORGE FREDERICK III (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:FREDERICK
Last Name:HOAGLIN
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:
Other - Last Name:HOAGLIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
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:
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:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2064122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist