Individual
MIMI M. HALLECK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4424 SPRINGFIELD RD, SUITE 100, GLEN ALLEN, VA 23060-3412
(804) 270-5353
(804) 270-0460
Mailing address
4424 SPRINGFIELD RD, SUITE 100, GLEN ALLEN, VA 23060-3412
(804) 270-5353
(804) 270-0460
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
007479
VA
Other
Enumeration date
12/13/2005
Last updated
07/08/2007
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