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General NPI Number Information
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NPI Number | 1023761608
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Entity Type | Individual
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Provider Name | HAYLEY CHRISTINE MATHIE DDS
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Gender | Female
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 1270 W STADIUM BLVD
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-6007
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Country | US
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Telephone | 573-635-2571
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Fax |
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Provider Business Mailing Address
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Address Line | 6400 COBBLE CREEK DR
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City | COLUMBIA
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State | MO
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Zip | 65201-2933
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Country | US
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Telephone | 612-859-1541
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2025011984
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License Number State | MO
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