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General NPI Number Information
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NPI Number | 1487727962
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Entity Type | Organization
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Legal Business Name | DAVID S HAYNES DMD INC
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 850 KAMEHAMEHA HWY SUITE 155
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City | PEARL CITY
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State | HI
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Zip | 96782-2657
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Country | US
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Telephone | 808-454-2565
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Fax | 808-454-2569
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Provider Business Mailing Address
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Address Line | 850 KAMEHAMEHA HWY SUITE 155
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City | PEARL CITY
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State | HI
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Zip | 96782-2657
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Country | US
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Telephone | 808-454-2565
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Fax | 808-454-2569
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. DAVID SCOTT HAYNES
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Credential | DMD
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Telephone | 808-454-2565
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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 | DT1916
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License Number State | HI
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