Provider Demographics
NPI:1275770075
Name:HAGLUND, ROBERT R JR (DMD, MDS, PA)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:R
Last Name:HAGLUND
Suffix:JR
Gender:M
Credentials:DMD, MDS, PA
Other - Prefix:
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Mailing Address - Street 1:8927 J M KEYNES DR # 330
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-8433
Mailing Address - Country:US
Mailing Address - Phone:704-594-9808
Mailing Address - Fax:704-799-6539
Practice Address - Street 1:8927 J M KEYNES DR # 330
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-8433
Practice Address - Country:US
Practice Address - Phone:704-594-9808
Practice Address - Fax:704-799-6539
Is Sole Proprietor?:No
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC77271223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics