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General NPI Number Information
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NPI Number | 1437319878
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Entity Type | Organization
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Legal Business Name | DR. HAGEMAN DDS
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Dates
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Enumeration Date | 06/10/2008
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Last Update Date | 06/10/2008
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Provider Practice Location Address
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Address Line | 3606 MARVIN D LOVE FWY
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City | DALLAS
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State | TX
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Zip | 75224-4442
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Country | US
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Telephone | 214-371-4763
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Fax | 214-372-6057
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Provider Business Mailing Address
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Address Line | 3606 MARVIN D LOVE FWY
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City | DALLAS
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State | TX
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Zip | 75224-4442
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Country | US
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Telephone | 214-371-4763
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Fax | 214-372-6057
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Authorized Official
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Title or Position | INSURANCE AND BILLING REP.
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Name | MRS. JOANIE MARIE MATHESON
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Credential |
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Telephone | 214-371-4763
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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 | 8184
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License Number State | TX
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