Individual
CAROL HALLORAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1950 PLYMOUTH AVE, WATERLOO, IA 50702-3524
(319) 291-3908
(319) 291-4077
Mailing address
1950 PLYMOUTH AVE, WATERLOO, IA 50702-3524
(319) 230-4554
(319) 291-4077
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
07465
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076372
—
IA
Enumeration date
12/09/2005
Last updated
09/27/2012
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