Individual
DR. BRIAN HALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
602 W 6TH ST, ROLLA, MO 65401-2941
(573) 364-7969
Mailing address
PO BOX 393, ROLLA, MO 65402-0393
(573) 364-7969
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13842
MO
Other
Enumeration date
07/18/2007
Last updated
09/22/2008
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