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General NPI Number Information
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NPI Number | 1518443738
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Entity Type | Individual
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Provider Name | DEANDRA HAYES DMD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2018
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 1001 S 41ST ST E
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City | MUSKOGEE
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State | OK
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Zip | 74403-6253
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Country | US
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Telephone | 918-781-6580
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Fax |
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Provider Business Mailing Address
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Address Line | 817 S LAKE REGION RD
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City | HULBERT
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State | OK
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Zip | 74441-2698
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Country | US
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Telephone | 918-931-9582
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7083
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 1223D0001X
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Taxonomy Name | Public Health Dentistry
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License Number | 7083
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License Number State | OK
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