Provider Demographics
NPI:1235149758
Name:HAYWARD, MICHAEL D (DDS)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
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 1:600 N NORTH CT
Mailing Address - Street 2:SUITE 220
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60067-8155
Mailing Address - Country:US
Mailing Address - Phone:847-359-7980
Mailing Address - Fax:847-359-7585
Practice Address - Street 1:600 N NORTH CT
Practice Address - Street 2:SUITE 220
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60067-8155
Practice Address - Country:US
Practice Address - Phone:847-359-7980
Practice Address - Fax:847-359-7585
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics