Provider Demographics
NPI:1124452198
Name:JOEL HAYDEN, DDS, PLLC
Entity type:Organization
Organization Name:JOEL HAYDEN, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:989-754-2171
Mailing Address - Street 1:301 E GENESEE AVE
Mailing Address - Street 2:STE. 203
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1242
Mailing Address - Country:US
Mailing Address - Phone:989-754-2171
Mailing Address - Fax:989-752-3678
Practice Address - Street 1:301 E GENESEE AVE
Practice Address - Street 2:STE. 203
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48607-1242
Practice Address - Country:US
Practice Address - Phone:989-754-2171
Practice Address - Fax:989-752-3678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI179961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty