Provider Demographics
NPI:1366562274
Name:FREEMAN, HOGAN BERNARD (DMD)
Entity type:Individual
Prefix:DR
First Name:HOGAN
Middle Name:BERNARD
Last Name:FREEMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 FOLLY RD
Mailing Address - Street 2:SUITE #T
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-3907
Mailing Address - Country:US
Mailing Address - Phone:843-795-9856
Mailing Address - Fax:843-795-1244
Practice Address - Street 1:915 FOLLY RD
Practice Address - Street 2:SUITE #T
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-3907
Practice Address - Country:US
Practice Address - Phone:843-795-9856
Practice Address - Fax:843-795-1244
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice