Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 5151 | AZ |
NPI | 1790838605 |
---|---|
Provider Name | Dr. Donald R. Hoaglin |
First Address | Glendale, AZ 85308-6093 |
Second Address | Glendale, AZ 85308-6093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 08/07/2007 |