# DR. HAGEMAN DDS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Dr. Hageman Family Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437319878
- **Authorized official:** MRS. JOANIE MARIE MATHESON (INSURANCE AND BILLING REP.)
- **Authorized official phone:** (214) 371-4763

## Contact information

- **Practice address:** 3606 MARVIN D LOVE FWY, DALLAS, TX 75224-4442
- **Practice address phone:** (214) 371-4763
- **Practice address fax:** (214) 372-6057
- **Mailing address:** 3606 MARVIN D LOVE FWY, DALLAS, TX 75224-4442
- **Mailing address phone:** (214) 371-4763
- **Mailing address fax:** (214) 372-6057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 8184 | TX | Yes |

## Other

- **Enumeration date:** 06/10/2008
- **Last updated:** 06/10/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 009688501 | — | TX |