Individual
DR. JON HALLIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
201 4TH AVE NW, ROSEAU, MN 56751-1033
(218) 463-2553
(218) 463-9464
Mailing address
201 4TH AVE NW, ROSEAU, MN 56751-1033
(218) 463-2553
(218) 463-9464
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D13518
MN
Other
Enumeration date
06/02/2015
Last updated
07/21/2022
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