Provider Demographics
NPI:1376695304
Name:HAYES FAMILY DENTISTRY
Entity Type:Organization
Organization Name:HAYES FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:D
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:931-526-1614
Mailing Address - Street 1:620 E 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-1810
Mailing Address - Country:US
Mailing Address - Phone:931-526-1614
Mailing Address - Fax:931-525-1236
Practice Address - Street 1:620 E 10TH STREET
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-1810
Practice Address - Country:US
Practice Address - Phone:931-526-1614
Practice Address - Fax:931-525-1236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN46871223G0001X
TNTN46691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty