MEDICARE: DR. BRANDON ERNEST HAGLER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	5929	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457525743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRANDON ERNEST HAGLER DDS

Provider Business Mailing Address
First Line	:	1201 CANAL ST APT 501
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70112-2673
Country	:	US
Telephone Number	:	504-906-0099
Fax Number	:	504-309-6666

Provider Business Practice Location Address
First Line	:	7023 READ LN
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70127-2366
Country	:	US
Telephone Number	:	504-244-0177
Fax Number	:	504-309-9666

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2008
Last Update Date	:	02/28/2013

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