Provider Demographics
NPI:1568670578
Name:HAYS, DIXON ALAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DIXON
Middle Name:ALAN
Last Name:HAYS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 S. CENTRAL AVE
Mailing Address - Street 2:PO BOX 2270
Mailing Address - City:UMATILLA
Mailing Address - State:FL
Mailing Address - Zip Code:32784-2270
Mailing Address - Country:US
Mailing Address - Phone:352-669-3185
Mailing Address - Fax:
Practice Address - Street 1:285 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:UMATILLA
Practice Address - State:FL
Practice Address - Zip Code:32784-2270
Practice Address - Country:US
Practice Address - Phone:352-669-3185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL75121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice