Individual
MRS. JESSICA NICOLE HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
875 UNION AVE, MEMPHIS, TN 38163-1030
(510) 566-3802
Mailing address
2834 HONEY TREE DR, GERMANTOWN, TN 38138-7210
(510) 566-3802
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10747
NC
122300000X
Dentist
Primary
11205
TN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/10/2016
Last updated
12/18/2020
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