Organization
VAN HALA DENTAL HUDSON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT A VAN HALA DDS (OWNER/DENTIST)
(330) 650-0353
Entity
Organization
Contact information
Practice address
46 RAVENNA ST STE A6, HUDSON, OH 44236-3058
(330) 650-0353
(330) 650-1259
Mailing address
46 RAVENNA ST STE A6, HUDSON, OH 44236-3058
(330) 650-0353
(330) 650-1259
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22586
OH
Other
Enumeration date
01/16/2018
Last updated
01/16/2018
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