Provider Demographics
NPI:1346979556
Name:MOLINA, HAILEY MARIE (DMD)
Entity type:Individual
Prefix:
First Name:HAILEY
Middle Name:MARIE
Last Name:MOLINA
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 158TH ST N
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33478-8513
Mailing Address - Country:US
Mailing Address - Phone:954-604-0851
Mailing Address - Fax:
Practice Address - Street 1:13430 158TH ST N
Practice Address - Street 2:
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33478-8513
Practice Address - Country:US
Practice Address - Phone:954-604-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN26918122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist