Individual
KEVIN M. HALUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1035 E WILCOX AVE, WHITE CLOUD, MI 49349-8794
(231) 689-1608
(231) 689-3162
Mailing address
1615 MICHIGAN AVE, BALDWIN, MI 49304-7984
(231) 745-2736
(231) 745-0412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901014001
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4718084
—
MI
01
—
D800473
BLUE CROSS BLUE SHEILD
MI
Enumeration date
05/27/2006
Last updated
10/20/2021
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