Individual
JESSICA M HALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
806 S PINE ST, STILLWATER, OK 74074-4349
(405) 377-1155
(405) 377-1914
Mailing address
806 S PINE ST, STILLWATER, OK 74074-4349
(405) 377-1155
(405) 377-1914
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5711
OK
1223G0001X
General Practice Dentistry
60291
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9177275
DORAL
KS
Enumeration date
12/26/2005
Last updated
07/09/2007
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