Individual
DR. DIANA M HAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
3043 JOHN F KENNEDY BLVD, JERSEY CITY, NJ 07306-3605
(201) 484-5483
Mailing address
3043 JOHN F KENNEDY BLVD, JERSEY CITY, NJ 07306-3605
(201) 484-5483
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22DI02415900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0226556
—
NJ
Enumeration date
01/29/2009
Last updated
09/18/2019
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