Provider Demographics
NPI:1871263483
Name:HAYES, JULIE MARIE (DMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:HAYES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11239 W PHILLIP JACOB DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85378-6920
Mailing Address - Country:US
Mailing Address - Phone:801-390-8741
Mailing Address - Fax:
Practice Address - Street 1:7450 INDIO AVE
Practice Address - Street 2:
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-6044
Practice Address - Country:US
Practice Address - Phone:801-390-8741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-15
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD011171122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist