Provider Demographics
NPI:1386137800
Name:HAYNES, MORGAN (DDS)
Entity type:Individual
Prefix:
First Name:MORGAN
Middle Name:
Last Name:HAYNES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25145 PANTHER BEND CT UNIT 1208
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3784
Mailing Address - Country:US
Mailing Address - Phone:281-165-8838
Mailing Address - Fax:
Practice Address - Street 1:245 INTERSTATE 45 S STE D
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-4986
Practice Address - Country:US
Practice Address - Phone:936-649-8137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-09
Last Update Date:2018-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX340801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice