Organization
BRIAN HALLER DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN HALLER DMD (OWNER)
(573) 364-7969
Entity
Organization
Contact information
Practice address
602 W 6TH ST, ROLLA, MO 65401-2941
(573) 364-7969
Mailing address
PO BOX 393, ROLLA, MO 65402-0393
(573) 364-7969
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
013842
MO
Other
Enumeration date
10/15/2008
Last updated
10/15/2008
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