| Kevin P. Hagerty Dmd Pc | |
|
61 Cedar Ave Unit 5 East Greenwich RI 02818-3190 | |
| (401) 884-4874 | |
| (401) 884-4928 |
| Full Name | Kevin P. Hagerty Dmd Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 61 Cedar Ave Unit 5, East Greenwich, Rhode Island |
| Authorized Official Name and Position | Kevin Patrick Hagerty (OWNER) |
| Authorized Official Contact | 4018844874 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin P. Hagerty Dmd Pc 61 Cedar Avenue, #5 East Greenwich RI 02818 Ph: (401) 884-4874 | Kevin P. Hagerty Dmd Pc 61 Cedar Ave Unit 5 East Greenwich RI 02818-3190 Ph: (401) 884-4874 |
| NPI Number | 1518191170 |
|---|---|
| Provider Enumeration Date | 05/12/2009 |
| Last Update Date | 05/12/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518191170 | NPI | - | NPPES |
| 8048-6 | Other | RI | BLUE CROSS RI DENTAL |
| KH00257 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 2155 (Rhode Island) | Primary |
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John S. Kacewicz, D.m.d. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 990 Main St, East Greenwich, RI 02818 Phone: 401-884-6500 Fax: 401-886-4432 | |
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