Provider Demographics
NPI:1710328885
Name:HAYES, MOLLY K (DDS)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:K
Last Name:HAYES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 S 2ND ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:ST CHARLES
Mailing Address - State:IL
Mailing Address - Zip Code:60174-2812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 S 2ND ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:ST CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2812
Practice Address - Country:US
Practice Address - Phone:630-584-0026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029522122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist