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Organization
HALES DENTAL PRACTICE, PC
Active
Organization
HALES DENTAL PRACTICE, PC
Active
Other names
Angellift Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMIE BOB HALES DDS (OWNER)
(541) 474-1100
Entity
Organization
Contact information
Practice address
781 NE 7TH ST, SUITE B, GRANTS PASS, OR 97526-1654
(541) 474-1100
(541) 471-1103
Mailing address
781 NE 7TH ST, SUITE B, GRANTS PASS, OR 97526-1654
(541) 474-1100
(541) 471-1103
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
D6777
OK
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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