Individual
HAILEY E BIVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3302 GASTON AVE, DALLAS, TX 75246-2013
(214) 828-8140
Mailing address
3302 GASTON AVE, DALLAS, TX 75246-2013
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
38750
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2022
Last updated
07/30/2022
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