Provider Demographics
NPI:1225121254
Name:HAYWARD, JAMES S (DDS)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:S
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 W WASHINGTON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4073
Mailing Address - Country:US
Mailing Address - Phone:906-226-9992
Mailing Address - Fax:906-226-9982
Practice Address - Street 1:989 W WASHINGTON ST STE 104
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4073
Practice Address - Country:US
Practice Address - Phone:906-226-9992
Practice Address - Fax:906-226-9982
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJH0104331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI88131OtherDENTAL DENTAL PROVIDER NU
MID801057OtherBCBS DENTAL PROVIDER NUMB