Provider Demographics
NPI:1629244959
Name:HAGGERTY, CHRISTOPHER JOHN (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JOHN
Last Name:HAGGERTY
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
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Mailing Address - Street 1:3600 NE RALPH POWELL RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64064-2369
Mailing Address - Country:US
Mailing Address - Phone:816-554-8300
Mailing Address - Fax:816-554-8303
Practice Address - Street 1:3600 NE RALPH POWELL RD
Practice Address - Street 2:SUITE D
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-2369
Practice Address - Country:US
Practice Address - Phone:816-554-8300
Practice Address - Fax:816-554-8303
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAS-3501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
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MO002514127OtherUNITED CONCORDIA
MO273850017OtherGUARDIAN
MO1700482249OtherGEHA
MO273850017OtherMETLIFE
MO273850017OtherDELTA OF KANSAS
MO273850017OtherHUMANA
MO2002013152OtherCIGNA
MO40397051OtherBLUE CROSS BLUE SHEILD OF KANSAS CITY