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Organization
KEVIN P. HAGERTY DMD PC
Active
Organization
KEVIN P. HAGERTY DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN PATRICK HAGERTY DMD (OWNER)
(401) 884-4874
Entity
Organization
Contact information
Practice address
61 CEDAR AVE UNIT 5, EAST GREENWICH, RI 02818-3190
(401) 884-4874
(401) 884-4928
Mailing address
61 CEDAR AVENUE, #5, EAST GREENWICH, RI 02818
(401) 884-4874
(401) 884-4928
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2155
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8048-6
BLUE CROSS RI DENTAL
RI
05
—
KH00257
—
RI
Enumeration date
05/12/2009
Last updated
05/12/2009
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