Individual
MR. WAYNE R HAWKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3015 S PROVIDENCE RD, SUITE 4, COLUMBIA, MO 65203-3670
(573) 449-2941
(573) 443-3427
Mailing address
3015 S PROVIDENCE RD, SUITE 4, COLUMBIA, MO 65203-3670
(573) 449-2941
(573) 443-3427
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011312
MO
Other
Enumeration date
12/20/2011
Last updated
12/20/2011
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