Organization
HALES DENTAL PRACTICE, PC
Active
Other names
Angellift Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMIE BOB HALES DDS (OWNER)
(541) 474-1100
Entity
Organization
Contact information
Practice address
781 NE 7TH ST, SUITE B, GRANTS PASS, OR 97526-1654
(541) 474-1100
(541) 471-1103
Mailing address
781 NE 7TH ST, SUITE B, GRANTS PASS, OR 97526-1654
(541) 474-1100
(541) 471-1103
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
D6777
OK
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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