Individual
MR. JESSE PAUL HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5 9TH AVE N, CASSELTON, ND 58012-3339
(701) 347-5345
(701) 347-4876
Mailing address
PO BOX 520, CASSELTON, ND 58012-0520
(701) 347-5345
(701) 347-4876
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2014
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41435
—
ND
Enumeration date
10/16/2006
Last updated
11/10/2009
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