Provider Demographics
NPI:1679676134
Name:HAYES DENTAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:HAYES DENTAL ASSOCIATES, P.C.
Other - Org Name:HAYES FAMILY DENISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER 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:PO BOX 665
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072
Mailing Address - Country:US
Mailing Address - Phone:804-642-2212
Mailing Address - Fax:804-642-9026
Practice Address - Street 1:3073 GEORGE WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:HAYES
Practice Address - State:VA
Practice Address - Zip Code:23072
Practice Address - Country:US
Practice Address - Phone:804-642-2212
Practice Address - Fax:804-642-9026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA6140122300000X
VA0401411190122300000X
VA0401008284261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty