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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285760462 | NPPES |
| California | Other | 523082 | DENTI-CAL NUMBER |
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