# HAGGERTY DENTAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Haggerty Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780103895
- **Authorized official:** DR. BRETT RYAN HAGGERTY DDS (OWNER/ PARTNER)
- **Authorized official phone:** (505) 268-3384

## Contact information

- **Practice address:** 5124 ZUNI RD SE, ALBUQUERQUE, NM 87108-2833
- **Practice address phone:** (505) 268-3384
- **Practice address fax:** (505) 265-5554
- **Mailing address:** 5124 ZUNI RD SE, ALBUQUERQUE, NM 87108-2833
- **Mailing address phone:** (505) 268-3384
- **Mailing address fax:** (505) 265-5554

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DD4701 | NM | Yes |

## Other

- **Enumeration date:** 09/11/2017
- **Last updated:** 07/21/2022