Provider Demographics
NPI:1144383183
Name:HAYES, RICHARD (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:HAYES
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DUTTON ST
Mailing Address - Street 2:
Mailing Address - City:RIDLEY PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19078-2308
Mailing Address - Country:US
Mailing Address - Phone:610-521-2222
Mailing Address - Fax:610-521-4274
Practice Address - Street 1:101 DUTTON ST
Practice Address - Street 2:
Practice Address - City:RIDLEY PARK
Practice Address - State:PA
Practice Address - Zip Code:19078-2308
Practice Address - Country:US
Practice Address - Phone:610-521-2222
Practice Address - Fax:610-521-4274
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0180871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics