Provider Demographics
NPI:1346350113
Name:HAGY, ROBERT GRAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GRAY
Last Name:HAGY
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 1:4930 TOWNSHIP ROAD 127 NE
Mailing Address - Street 2:
Mailing Address - City:NEW LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43764-9717
Mailing Address - Country:US
Mailing Address - Phone:740-342-2593
Mailing Address - Fax:740-342-4156
Practice Address - Street 1:257 E JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:NEW LEXINGTON
Practice Address - State:OH
Practice Address - Zip Code:43764-1060
Practice Address - Country:US
Practice Address - Phone:740-342-4156
Practice Address - Fax:740-342-4156
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH20456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist