Individual
BRYAN HALSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
15 RUTH DR, NEWNAN, GA 30265-2317
(770) 253-3171
Mailing address
16 ONTARIO CT, NEWNAN, GA 30263-8706
(912) 286-0352
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN015900
GA
Other
Enumeration date
03/30/2019
Last updated
07/23/2020
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