Organization
VAN HALA DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT ADDISON VAN HALA DDS (DENTIST)
(330) 494-0646
Entity
Organization
Contact information
Practice address
1515 PORTAGE ST NW # 1, NORTH CANTON, OH 44720-2290
(330) 494-0646
Mailing address
1515 PORTAGE ST NW # 1, NORTH CANTON, OH 44720-2290
(330) 494-0646
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30022586
OH
Other
Enumeration date
01/30/2018
Last updated
01/30/2018
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