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General NPI Number Information
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NPI Number | 1073244109
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Entity Type | Individual
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Provider Name | LAURA ELIZABETH HAGERTY DDS
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Gender | Female
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Dates
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Enumeration Date | 06/20/2022
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 11701 BELCHER RD S STE 103
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City | LARGO
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State | FL
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Zip | 33773-5116
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Country | US
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Telephone | 727-213-8548
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Fax |
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Provider Business Mailing Address
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Address Line | 1962 ROCKY POINTE DR
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City | LAKELAND
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State | FL
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Zip | 33813-1968
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901601440
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN30209
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License Number State | FL
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