# DAVID C. HAGEDORN DMD PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811094097
- **Authorized official:** DR. DAVID CHARLES HAGEDORN DMD (PRESIDENT)
- **Authorized official phone:** (859) 291-7621

## Contact information

- **Practice address:** 340 FAIRFIELD AVE, BELLEVUE, KY 41073-1010
- **Practice address phone:** (859) 291-7621
- **Mailing address:** 340 FAIRFIELD AVE, BELLEVUE, KY 41073-1010
- **Mailing address phone:** (859) 291-7621

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 4747 | KY | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 09/16/2008