Individual
TREVOR HALLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2222 E CEDAR AVE, FLAGSTAFF, AZ 86004-1988
(928) 774-4412
Mailing address
2222 E CEDAR AVE, FLAGSTAFF, AZ 86004-1988
(928) 774-4412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D010734
AZ
Other
Enumeration date
06/18/2020
Last updated
06/18/2020
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