Healthcare Provider Details

I. General information

NPI: 1487744470
Provider Name (Legal Business Name): HILARY LYNN HALEY DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 W SD HIGHWAY 46
WAGNER SD
57380-9369
US

IV. Provider business mailing address

412 W SD HIGHWAY 46
WAGNER SD
57380-9369
US

V. Phone/Fax

Practice location:
  • Phone: 605-384-3400
  • Fax: 605-384-3440
Mailing address:
  • Phone: 605-384-3400
  • Fax: 605-384-3440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberM873
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: