Individual
DR. ELIZABETH HAGERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
112 E 10TH ST, GREENSBURG, IN 47240-8202
(812) 663-2503
Mailing address
813 E ERDMANN RD S, GREENSBURG, IN 47240-8661
(317) 496-9569
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010549A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200859770A
—
IN
Enumeration date
05/03/2007
Last updated
05/29/2009
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