Individual
KATELYN CHRISTIE HAGOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1610 TREMONT ST, BOSTON, MA 02120-1613
(617) 379-1966
Mailing address
8375 ARDMOOR DR, YPSILANTI, MI 48198-7077
(734) 660-5372
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN10000069
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/23/2023
Last updated
06/05/2024
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