Kyle Blake Hagen, D.M.D Valid NPI

Individual provider · General Practice Dentistry · East Alton, IL

NPI

1528139227

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

Sex

Male

Sole proprietor

Yes

Enumerated

2006-11-13

Last updated

2007-07-08