Individual
DR. CHARITY KEONNA HALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
310 CONTINENTAL DRIVE, SUTIE 106, JAL, NM 88252-2525
(753) 952-2095
(575) 395-2205
Mailing address
31 HITREE LN, ROCHESTER, NY 14624-4740
(716) 860-6822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DB-2024-0058
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/03/2019
Last updated
06/24/2024
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