Individual
DR. HAYWOOD LEE HAMBRICK
Active
Individual
DR. HAYWOOD LEE HAMBRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
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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