Healthcare Provider Details
I. General information
NPI: 1285892976
Provider Name (Legal Business Name): PATRICK RAY HAYS D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/29/2008
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
412 W MAIN ST SUITE 1
BELGRADE MT
59714-3828
US
IV. Provider business mailing address
412 W MAIN ST SUITE 1
BELGRADE MT
59714-3828
US
V. Phone/Fax
- Phone: 406-388-8006
- Fax:
- Phone: 406-388-8006
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 1417 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: