Provider Demographics
NPI:1902828171
Name:HAGGERTY, CAROL LINDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:LINDA
Last Name:HAGGERTY
Suffix:
Gender:F
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:UNC SCHOOL OF DENTISTRY
Mailing Address - Street 2:3120 OLD DENTAL BLDG CB 7450
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27599-7450
Mailing Address - Country:US
Mailing Address - Phone:919-966-7575
Mailing Address - Fax:
Practice Address - Street 1:UNC SCHOOL OF DENTISTRY
Practice Address - Street 2:3120 OLD DENTAL BLDG CB 7450
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-7450
Practice Address - Country:US
Practice Address - Phone:919-966-7575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDTP3971223G0001X
MI2910156071223G0001X
NC00961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice