Provider Demographics
NPI:1972176642
Name:SALLY HAYS, DDS, PLLC
Entity Type:Organization
Organization Name:SALLY HAYS, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:HAYS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:979-776-6152
Mailing Address - Street 1:2901 E 29TH ST STE 117
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2691
Mailing Address - Country:US
Mailing Address - Phone:979-776-6152
Mailing Address - Fax:
Practice Address - Street 1:2901 E 29TH ST STE 117
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2691
Practice Address - Country:US
Practice Address - Phone:979-776-6152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental