Hagen, Kyle Blake

Hagen, Kyle Blake is an sole proprietor health care provider with primary practice located at 96 S 9Th St , East Alton IL 62024-1715. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Hagen, Kyle Blake can be contacted via phone (618) 259-1400.

Contact Information

Primary practice address
96 S 9Th St East Alton IL 62024-1715
Phone: (618) 259-1400
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X Illinois

Profile Details

NPI number 1528139227
LBN Legal business name Hagen, Kyle Blake
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 13th, 2006
Last updated Jul 8th, 2007 - about 17 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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