Michael Theodore Hagley, DDS
NPI #1972616605 in Grand Rapids, Minnesota
Provider Information
- NPI Number
- 1972616605
- Entity Type
- Individual
- Name
- Michael Theodore Hagley, DDS
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Aug 16, 2006
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 220 SE 21ST ST
- City
- Grand Rapids
- State
- Minnesota
- ZIP Code
- 55744-4268
- Phone
- (218) 326-3438
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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