Healthcare Provider Details

I. General information

NPI: 1750246534
Provider Name (Legal Business Name): ALHALASA DENTAL CORPORATION.INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

558 S PASEO DOROTEA STE 9
PALM SPRINGS CA
92264-1429
US

IV. Provider business mailing address

558 S PASEO DOROTEA STE 9
PALM SPRINGS CA
92264-1429
US

V. Phone/Fax

Practice location:
  • Phone: 760-318-0101
  • Fax:
Mailing address:
  • Phone: 760-318-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. EDDIE HALASA
Title or Position: OWNER/CEO
Credential: DDS,MSD
Phone: 661-717-7611