Organization
DAVID J. HAGSTROM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID JEROME HAGSTROM D.D.S. (OWNER)
(507) 288-1744
Entity
Organization
Contact information
Practice address
2112 VIKING DR NW, ROCHESTER, MN 55901-3522
(507) 288-1744
(507) 292-5776
Mailing address
2112 VIKING DR NW, ROCHESTER, MN 55901-3522
(507) 288-1744
(507) 292-5776
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11449
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1348318
TRI CARE ID NUMBER
MN
01
—
39492MA
BLUE CROSS BLUE SHIELD
MN
01
—
9175780
DORAL DENTAL IDENTIFIER
MN
01
—
D11449
LICENSE NUMBER
MN
Enumeration date
12/04/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us