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General NPI Number Information
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NPI Number | 1306907274
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Entity Type | Individual
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Provider Name | MARK F. HALEK D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 660 EXECUTIVE PARK CT STE 1600
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City | APOPKA
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State | FL
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Zip | 32703-6045
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Country | US
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Telephone | 407-774-4433
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Fax | 407-774-8475
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Provider Business Mailing Address
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Address Line | 660 EXECUTIVE PARK CT STE 1600
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City | APOPKA
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State | FL
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Zip | 32703-6045
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Country | US
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Telephone | 407-774-4433
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Fax | 407-774-8475
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN0012703
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License Number State | FL
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