Provider Demographics
NPI:1295771442
Name:HAYMORE, JESS A (DDS)
Entity type:Individual
Prefix:DR
First Name:JESS
Middle Name:A
Last Name:HAYMORE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 E INNOVATION PARK DR
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-1963
Mailing Address - Country:US
Mailing Address - Phone:520-297-2574
Mailing Address - Fax:520-297-4627
Practice Address - Street 1:9000 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7400
Practice Address - Country:US
Practice Address - Phone:520-297-2514
Practice Address - Fax:520-297-4627
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ56981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice