Healthcare Provider Details

I. General information

NPI: 1447875489
Provider Name (Legal Business Name): CONNOR MICHAEL HAGERTY D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2020
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1895 PLAZA DR STE 130
EAGAN MN
55122-4601
US

IV. Provider business mailing address

2200 COUNTY ROAD C W STE 2210
ROSEVILLE MN
55113-2551
US

V. Phone/Fax

Practice location:
  • Phone: 651-454-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD14994
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: