Provider Demographics
NPI:1881016053
Name:WOOLFSON, HAYLEY ALANA (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:HAYLEY
Middle Name:ALANA
Last Name:WOOLFSON
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:463688 STATE ROAD 200 STE 5
Mailing Address - Street 2:
Mailing Address - City:YULEE
Mailing Address - State:FL
Mailing Address - Zip Code:32097-0304
Mailing Address - Country:US
Mailing Address - Phone:904-849-4500
Mailing Address - Fax:
Practice Address - Street 1:463688 STATE ROAD 200 STE 5
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097-0304
Practice Address - Country:US
Practice Address - Phone:904-849-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-07
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 196421223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics