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Organization
LAKEWOOD ORAL AND MAXILLOFACIAL SURGERY SPECIALISTS
Active
Organization
LAKEWOOD ORAL AND MAXILLOFACIAL SURGERY SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOPHER J HAGGERTY DDS, MD (MEMBER)
(816) 554-8300
Entity
Organization
Contact information
Practice address
3600 NE RALPH POWELL RD, SUITE D, LEES SUMMIT, MO 64064-2369
(816) 554-8300
(816) 554-8303
Mailing address
3600 NE RALPH POWELL RD, SUITE D, LEES SUMMIT, MO 64064-2369
(816) 554-8300
(816) 554-8303
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2002013152
MO
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
60577
KS
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
04-34622
KS
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2008034915
MO
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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