Provider Demographics
NPI:1154325546
Name:HAGGERTY, RAYMOND CARPENTER III (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:CARPENTER
Last Name:HAGGERTY
Suffix:III
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-6296
Mailing Address - Country:US
Mailing Address - Phone:610-866-3161
Mailing Address - Fax:610-866-3166
Practice Address - Street 1:204 E MARKET ST
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6296
Practice Address - Country:US
Practice Address - Phone:610-866-3161
Practice Address - Fax:610-866-3166
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS018858L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice