Provider Demographics
NPI:1053609818
Name:HAGANI, ROBERT MARC (DMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARC
Last Name:HAGANI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 BRONX RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-7013
Mailing Address - Country:US
Mailing Address - Phone:914-776-1122
Mailing Address - Fax:
Practice Address - Street 1:850 BRONX RIVER RD
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-7013
Practice Address - Country:US
Practice Address - Phone:914-776-1122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040228122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist