Individual
DR. KEVIN R HALLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
512 BECKER AVE SW, WILLMAR, MN 56201-3232
(320) 235-2551
(320) 235-0549
Mailing address
512 BECKER AVE SW, WILLMAR, MN 56201-3232
(320) 235-2551
(320) 235-0549
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9069
MN
Other
Enumeration date
01/20/2007
Last updated
07/08/2007
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