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Individual

DR. ALEXIS MARTHAJANE HALLISSEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
1264 NEXTON PKWY STE 202, SUMMERVILLE, SC 29486-2167
(854) 237-0876
Mailing address
23 WALKER ST, KITTERY, ME 03904-1728
(207) 439-2310

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
4412
ME
1223G0001X
General Practice Dentistry
03858
NH
1223G0001X
General Practice Dentistry
Primary
9840
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30309908
NH
Enumeration date
06/30/2010
Last updated
04/15/2025
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