Healthcare Provider Details

I. General information

NPI: 1275912891
Provider Name (Legal Business Name): ROBERT G HALE DDS APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2015
Last Update Date: 06/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6325 TOPANGA CANYON BLVD STE 435
WOODLAND HILLS CA
91367-2006
US

IV. Provider business mailing address

6325 TOPANGA CANYON BLVD STE 435
WOODLAND HILLS CA
91367-2006
US

V. Phone/Fax

Practice location:
  • Phone: 818-999-0900
  • Fax: 818-999-6927
Mailing address:
  • Phone: 818-999-0900
  • Fax: 818-999-6927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD29601
License Number StateCA

VIII. Authorized Official

Name: ROBERT HALE
Title or Position: OWNER
Credential: D.D.S.
Phone: 818-999-0900