Provider Demographics
NPI:1255430641
Name:HAGIN, JOYCE A (DMD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:A
Last Name:HAGIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36190 S CYPRESS DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-1522
Mailing Address - Country:US
Mailing Address - Phone:520-818-6584
Mailing Address - Fax:
Practice Address - Street 1:10550 N. LACANADA DR
Practice Address - Street 2:SUITE # 106
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85737
Practice Address - Country:US
Practice Address - Phone:520-575-5576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1213122300000X
AZ7473122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist