Provider Demographics
NPI:1861562480
Name:HAYES, TERRY S (DDS PC)
Entity type:Individual
Prefix:
First Name:TERRY
Middle Name:S
Last Name:HAYES
Suffix:
Gender:M
Credentials:DDS PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 NEW BYHALIA RD
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-3706
Mailing Address - Country:US
Mailing Address - Phone:901-850-0700
Mailing Address - Fax:901-850-0770
Practice Address - Street 1:384 NEW BYHALIA RD
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-3706
Practice Address - Country:US
Practice Address - Phone:901-850-0700
Practice Address - Fax:901-850-0770
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7246122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7246OtherTN LICENSE