Basic Information
| Provider Information | |||||||||
| NPI: | 1174009880 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAYS | ||||||||
| FirstName: | BART | ||||||||
| MiddleName: | WAYNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2040 FM 663 STE 420 | ||||||||
| Address2: | |||||||||
| City: | MIDLOTHIAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760656509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725284802 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2040 FM 663 STE 420 | ||||||||
| Address2: | |||||||||
| City: | MIDLOTHIAN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760656509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9725284802 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2018 | ||||||||
| LastUpdateDate: | 07/16/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 34343 | TX | Y | Dental Providers | Dentist | General Practice |
No ID Information.