Organization
WALLINGFORD SMILEMAKERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD MICHAEL HAYES DMD (OWNER/DENTIST)
(610) 874-5700
Entity
Organization
Contact information
Practice address
1 CHESTER RD, WALLINGFORD, PA 19086-6601
(610) 874-5700
(610) 872-5348
Mailing address
1 CHESTER RD, WALLINGFORD, PA 19086-6601
(610) 874-5700
(610) 872-5348
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DS028517L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7370300001
MEDICARE PCAN
PA
Enumeration date
11/17/2014
Last updated
11/18/2015
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