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General NPI Number Information
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NPI Number | 1649271198
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Entity Type | Organization
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Legal Business Name | DAVID J HAYUTIN DDS PROF LLC
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5055 E KENTUCKY AVE
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City | DENVER
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State | CO
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Zip | 80246
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Country | US
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Telephone | 303-757-8844
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Fax | 303-759-0994
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Provider Business Mailing Address
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Address Line | 5055 E KENTUCKY AVE
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City | DENVER
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State | CO
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Zip | 80246
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Country | US
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Telephone | 303-757-8844
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Fax | 303-759-0994
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Authorized Official
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Title or Position | MANAGER
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Name | DR. DAVID JOEL HAYUTIN
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Credential | DDS
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Telephone | 303-757-8844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 915
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 6181
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License Number State | CO
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