Provider Demographics
NPI:1063745479
Name:HAGAN, LOY ADAM (DDS)
Entity type:Individual
Prefix:DR
First Name:LOY
Middle Name:ADAM
Last Name:HAGAN
Suffix:
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 1:5 PLANTERS LN
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31411-2810
Mailing Address - Country:US
Mailing Address - Phone:912-272-7656
Mailing Address - Fax:
Practice Address - Street 1:5 PLANTERS LANE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31411
Practice Address - Country:US
Practice Address - Phone:912-272-7656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0150831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry