Provider Demographics
NPI:1518948298
Name:ASHLEY L. HAYES, D.D.S., INC.
Entity Type:Organization
Organization Name:ASHLEY L. HAYES, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-589-2515
Mailing Address - Street 1:100 PERRY ST
Mailing Address - Street 2:P. O. BOX 567
Mailing Address - City:LINDEN
Mailing Address - State:TN
Mailing Address - Zip Code:37096-0567
Mailing Address - Country:US
Mailing Address - Phone:931-589-2515
Mailing Address - Fax:931-589-3783
Practice Address - Street 1:100 PERRY STREET
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:TN
Practice Address - Zip Code:37096
Practice Address - Country:US
Practice Address - Phone:931-589-2515
Practice Address - Fax:931-589-3783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS30121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3205914Medicaid