Provider Demographics
NPI:1467011379
Name:WEST POINT FAMILY DENTAL PLLC
Entity type:Organization
Organization Name:WEST POINT FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYES
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:601-720-0007
Mailing Address - Street 1:3823 HIGHWAY 80 E STE 400
Mailing Address - Street 2:
Mailing Address - City:PEARL
Mailing Address - State:MS
Mailing Address - Zip Code:39208-4275
Mailing Address - Country:US
Mailing Address - Phone:601-664-9300
Mailing Address - Fax:
Practice Address - Street 1:26652 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-7544
Practice Address - Country:US
Practice Address - Phone:662-494-1869
Practice Address - Fax:662-494-7883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-13
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty