MEDICARE: DR. HAYLEY ALANA WOOLFSON D.M.D., M.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DN 19642	FL

General Provider Information

NPI Number	:	1881016053
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAYLEY ALANA WOOLFSON D.M.D., M.S.

Provider Business Mailing Address
First Line	:	463688 STATE ROAD 200 STE 5
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-0304
Country	:	US
Telephone Number	:	904-849-4500
Fax Number	:

Provider Business Practice Location Address
First Line	:	463688 STATE ROAD 200 STE 5
Second Line	:
City	:	YULEE
State	:	FL
Zip	:	32097-0304
Country	:	US
Telephone Number	:	904-849-4500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/07/2014
Last Update Date	:	04/05/2018

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