Provider Demographics
NPI:1982895348
Name:DR. ADAM M. HOGAN D.D.S.,PC
Entity Type:Organization
Organization Name:DR. ADAM M. HOGAN D.D.S.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-464-3514
Mailing Address - Street 1:2021 PLEASURE HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455-2709
Mailing Address - Country:US
Mailing Address - Phone:757-464-3514
Mailing Address - Fax:757-460-7815
Practice Address - Street 1:2021 PLEASURE HOUSE RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455-2709
Practice Address - Country:US
Practice Address - Phone:757-464-3514
Practice Address - Fax:757-460-7815
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty