Hagen, Justin Lee

Hagen, Justin Lee is an individual health care provider with primary practice located at 1150 Hazeltine Blvd , Chaska MN 55318-1004. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Hagen, Justin Lee can be contacted via phone (952) 361-0777.

Contact Information

Primary practice address
1150 Hazeltine Blvd Chaska MN 55318-1004
Phone: (952) 361-0777
Fax: (952) 361-6729
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X D12277 Minnesota

Profile Details

NPI number 1184781528
LBN Legal business name Hagen, Justin Lee
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 3rd, 2007
Last updated Jun 29th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1184781528 NPPES
Minnesota MEDICAID 698845800

Popular Providers