DR. Kyle Blake Hagen, D.M.D
NPI #1528139227 in East Alton, Illinois
Provider Information
- NPI Number
- 1528139227
- Entity Type
- Individual
- Name
- DR. Kyle Blake Hagen, D.M.D
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- D.M.D
- Enumeration Date
- Nov 13, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 96 S 9TH ST
- City
- East Alton
- State
- Illinois
- ZIP Code
- 62024-1715
- Phone
- (618) 259-1400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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