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General NPI Number Information
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NPI Number | 1174786206
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Entity Type | Individual
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Provider Name | ERIC WALLACE HAYES DDS
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Gender | Male
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 11/25/2009
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Provider Practice Location Address
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Address Line | 10105 PLANK RD. SUITE C
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City | CLINTON
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State | LA
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Zip | 70722
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Country | US
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Telephone | 225-683-9000
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Fax | 225-683-7000
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Provider Business Mailing Address
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Address Line | 01105 PLANK RD. SUITE C
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City | CLINTON
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State | LA
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Zip | 70722
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Country | US
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Telephone | 225-683-9000
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Fax | 225-683-7000
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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 | 5921
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License Number State | LA
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