Provider Demographics
NPI:1356508931
Name:HADLEY, DAVID LLOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LLOYD
Last Name:HADLEY
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 1:10429 LAGRIMA DE ORO RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3727
Mailing Address - Country:US
Mailing Address - Phone:505-291-8630
Mailing Address - Fax:
Practice Address - Street 1:10429 LAGRIMA DE ORO RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-3727
Practice Address - Country:US
Practice Address - Phone:505-291-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD29931223E0200X
VA04014112261223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics