Provider Demographics
NPI:1346445483
Name:HAYES, DANNY L (DMD)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:L
Last Name:HAYES
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:DANNY
Other - Middle Name:L
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:10771 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307
Mailing Address - Country:US
Mailing Address - Phone:219-663-9679
Mailing Address - Fax:219-663-9630
Practice Address - Street 1:10771 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307
Practice Address - Country:US
Practice Address - Phone:219-663-9679
Practice Address - Fax:219-663-9630
Is Sole Proprietor?:No
Enumeration Date:2007-06-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010456A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice