Individual
DR. RAYSHAM HAYAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
101 PROGRESS PKWY, SULLIVAN, MO 63080-2359
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(660) 885-8131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2021018765
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
400097855
—
MO
Enumeration date
06/01/2021
Last updated
12/19/2022
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