Individual
HAILEY TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
235 OSBORN AVE, RIVERHEAD, NY 11901-3077
(631) 320-5656
Mailing address
14 NORTH RD, NORTHPORT, NY 11768-2840
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
062734
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DDS104944
CA
Other
Enumeration date
12/12/2022
Last updated
12/12/2022
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