Provider Demographics
NPI:1346845427
Name:HAYNES FAMILY DENTAL CLINIC
Entity Type:Organization
Organization Name:HAYNES FAMILY DENTAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANNY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HAYNES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:501-321-1044
Mailing Address - Street 1:801 W GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-3528
Mailing Address - Country:US
Mailing Address - Phone:501-321-1044
Mailing Address - Fax:501-321-1865
Practice Address - Street 1:801 W GRAND AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-3528
Practice Address - Country:US
Practice Address - Phone:501-321-1044
Practice Address - Fax:501-321-1865
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-04
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental