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Organization

NATHAN G HALSTEAD DDS MS PC

Active
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Organization

NATHAN G HALSTEAD DDS MS PC

Active
Other names
Northwoods Orthodontics
Organization subpart
No

Provider details

NPI number
Authorized official
NONA G OLSON (OFFICE MANAGER)
(218) 722-5233
Entity
Organization

Contact information

Practice address
324 W SUPERIOR ST, SUITE 100, DULUTH, MN 55802-1701
(218) 722-5233
(218) 722-5661
Mailing address
324 W SUPERIOR ST, SUITE 100, DULUTH, MN 55802-1701
(218) 722-5233
(218) 722-5661

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6195-015
WI LICENSE NUMBER
WI
01
D11615
MINNESOTA LICENSE NUMBER
MN
Enumeration date
04/13/2016
Last updated
04/13/2016
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