Hagstrom, Carlton Bruce
Hagstrom, Carlton Bruce is an sole proprietor health care provider with primary practice located at 208 S Us Highway 12 , Fox Lake IL 60020-1928. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Hagstrom, Carlton Bruce can be contacted via phone (847) 587-5400.Contact Information
Primary practice address
208 S Us Highway 12
Fox Lake IL 60020-1928
Phone: (847) 587-5400
Fax: (847) 587-5400
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 19A15870 | Illinois |
Profile Details
| NPI number | 1144243585 |
|---|---|
| LBN Legal business name | Hagstrom, Carlton Bruce |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 26th, 2006 |
| 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.
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