Individual
DR. JOHN WESLEY HALLIBURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
22 N JEFFERSON AVE, COOKEVILLE, TN 38501-3334
(931) 526-3381
(931) 520-4804
Mailing address
22 N JEFFERSON AVE, COOKEVILLE, TN 38501-3334
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10520
TN
Other
Enumeration date
05/30/2017
Last updated
06/16/2018
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