MEDICARE: DR. EARLE ROBERT HALSBAND DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	10436	MA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	10436	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619043080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EARLE ROBERT HALSBAND DMD

Provider Business Mailing Address
First Line	:	9 LINDEN ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-2510
Country	:	US
Telephone Number	:	508-755-0008
Fax Number	:	508-770-0603

Provider Business Practice Location Address
First Line	:	9 LINDEN ST
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01609-2510
Country	:	US
Telephone Number	:	508-755-0008
Fax Number	:	508-770-0603

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2006
Last Update Date	:	09/11/2025

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