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NPI Code Detail

MEDICARE: HALSTEAD DENTAL CLINIC PA

MEDICARE: HALSTEAD DENTAL CLINIC PA
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
11223G0001XGeneral Practice Dentistry5857KS

General Provider Information

NPI Number : 1871630194
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALSTEAD DENTAL CLINIC PA
Provider Business Mailing Address
First Line : 212 MAIN ST
Second Line : P O BOX 209
City : HALSTEAD
State : KS
Zip : 67056-1913
Country : US
Telephone Number : 316-835-2070
Fax Number : 316-835-2008
Provider Business Practice Location Address
First Line : 212 MAIN ST
Second Line :
City : HALSTEAD
State : KS
Zip : 67056-1913
Country : US
Telephone Number : 316-835-2070
Fax Number : 316-835-2008
Authorized Official
Title or Position : DENTIST
Name : DR. ROBERT L SWEET
Credential : DDS PA
Telephone Number : 316-835-2070
Provider Enumeration Date : 01/30/2007
Last Update Date : 08/22/2020

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Directions to “HALSTEAD DENTAL CLINIC PA ” Practice Location

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