Provider Demographics
NPI:1992698302
Name:CLEGG, HAYDEN MICHAEL (DDS)
Entity type:Individual
Prefix:DR
First Name:HAYDEN
Middle Name:MICHAEL
Last Name:CLEGG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 ROBIN ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84335-1001
Mailing Address - Country:US
Mailing Address - Phone:435-890-9391
Mailing Address - Fax:
Practice Address - Street 1:664 ACACIA LN
Practice Address - Street 2:
Practice Address - City:RHINELANDER
Practice Address - State:WI
Practice Address - Zip Code:54501-2873
Practice Address - Country:US
Practice Address - Phone:715-365-8664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60018351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice