Individual
DR. HAYWOOD LEE HAMBRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1115 EAST 65TH ST, KANSAS CITY, MO 64131-1202
(816) 523-7766
(816) 523-2263
Mailing address
1115 EAST 65TH ST, KANSAS CITY, MO 64131-1202
(816) 523-7766
(816) 523-2263
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
012136591
MO
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
012136591
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00759025
BLUE CROSS
—
01
—
2181
DURAL
—
05
—
400750402
—
MO
Enumeration date
02/26/2007
Last updated
05/22/2013
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