Hagerty, Jacqueline Carol

Hagerty, Jacqueline Carol is an sole proprietor health care provider with primary practice located at 1921 Shasta Acres Rd , Mount Shasta CA 96067-9445. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Hagerty, Jacqueline Carol can be contacted via phone (530) 926-5253.

Contact Information

Primary practice address
1921 Shasta Acres Rd Mount Shasta CA 96067-9445
Phone: (530) 926-5253
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X RDHAP99 California

Profile Details

NPI number 1285760462
LBN Legal business name Hagerty, Jacqueline Carol
Credentials RDH,RDHAP, MBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 24th, 2007
Last updated Jul 8th, 2007 - about 19 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285760462 NPPES
California Other 523082 DENTI-CAL NUMBER

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