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General NPI Number Information
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NPI Number | 1912404914
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Entity Type | Organization
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Legal Business Name | HAYLEY A. WOOLFSON, D.M.D., M.S., L.L.C.
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Dates
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Enumeration Date | 04/07/2018
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Last Update Date | 06/11/2019
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Provider Practice Location Address
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Address Line | 463688 STATE ROAD 200 STE 5
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City | YULEE
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State | FL
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Zip | 32097-0304
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Country | US
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Telephone | 904-849-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 463688 STATE ROAD 200 STE 5
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City | YULEE
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State | FL
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Zip | 32097-0304
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | HAYLEY ALANA WOOLFSON
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Credential | DMD, MS
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Telephone | 954-547-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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