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Individual

DR. KEVIN JOE HALLGARTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
46 E STREETSBORO ST, HUDSON, OH 44236
(330) 650-1119
(330) 650-0836
Mailing address
5999 NICHOLSON DR, HUDSON, OH 44236-4409
(330) 650-5025

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30-01-9885
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30-01-9885
OHIO DENTAL LICENSE NUMBE
OH
Enumeration date
11/29/2006
Last updated
08/06/2018
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