MEDICARE: MR. DANNY L HAYES DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12010456A	IN

General Provider Information

NPI Number	:	1346445483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANNY L HAYES DMD

Provider Business Mailing Address
First Line	:	10771 RANDOLPH ST
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46307
Country	:	US
Telephone Number	:	219-663-9679
Fax Number	:	219-663-9630

Provider Business Practice Location Address
First Line	:	10771 RANDOLPH ST
Second Line	:
City	:	CROWN POINT
State	:	IN
Zip	:	46307
Country	:	US
Telephone Number	:	219-663-9679
Fax Number	:	219-663-9630

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2007
Last Update Date	:	07/08/2007

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