Organization
D H HALLIWELL JR DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID H HALLIWELL III DDS (PRESIDENT OWNER)
(601) 545-8615
Entity
Organization
Contact information
Practice address
314 SOUTH 25TH AVENUE, HATTIESBURG, MS 39401-7399
(601) 545-8615
(601) 545-8616
Mailing address
314 SOUTH 25TH AVENUE, HATTIESBURG, MS 39401-7399
(601) 545-8615
(601) 545-8616
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
180078
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
735590
UNITED CONCORDIA
PA
Enumeration date
05/01/2008
Last updated
05/01/2008
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