Provider Demographics
NPI:1053815233
Name:BURROW, HAYES K (DMD)
Entity Type:Individual
Prefix:
First Name:HAYES
Middle Name:K
Last Name:BURROW
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 1:3655 PEACHTREE RD NE UNIT 302
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-6102
Mailing Address - Country:US
Mailing Address - Phone:404-713-8104
Mailing Address - Fax:
Practice Address - Street 1:3655 PEACHTREE RD NE UNIT 302
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-6102
Practice Address - Country:US
Practice Address - Phone:404-713-8104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN123269122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist