Provider Demographics
NPI:1376905547
Name:HAYES COSMETIC & FAMILY DENTISTRY
Entity Type:Organization
Organization Name:HAYES COSMETIC & FAMILY DENTISTRY
Other - Org Name:A DIVISION OF ATLANTIC DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-642-2212
Mailing Address - Street 1:3224 GEORGE WASHINGTON MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-3312
Mailing Address - Country:US
Mailing Address - Phone:804-642-2212
Mailing Address - Fax:
Practice Address - Street 1:3224 GEORGE WASHINGTON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072-3312
Practice Address - Country:US
Practice Address - Phone:804-642-2212
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLANTIC DENTAL CARE ,PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-25
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401007435122300000X
VA0401008284122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty