Individual
DR. JOHN EDWARD HALVERSEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 490-1881
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019021620
IL
1223G0001X
General Practice Dentistry
019-021620
IL
Other
Enumeration date
05/10/2007
Last updated
08/26/2025
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