Provider Demographics
NPI:1427400365
Name:FAULKNER, HAYLEY GALIT (DDS, MASC)
Entity Type:Individual
Prefix:DR
First Name:HAYLEY
Middle Name:GALIT
Last Name:FAULKNER
Suffix:
Gender:F
Credentials:DDS, MASC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 25TH AVE S
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1513
Mailing Address - Country:US
Mailing Address - Phone:612-659-4900
Mailing Address - Fax:612-659-4901
Practice Address - Street 1:701 25TH AVE S
Practice Address - Street 2:SUITE 400
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1513
Practice Address - Country:US
Practice Address - Phone:612-659-4900
Practice Address - Fax:612-659-4901
Is Sole Proprietor?:No
Enumeration Date:2016-07-04
Last Update Date:2016-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR649390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program