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General NPI Number Information
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NPI Number | 1518321710
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Entity Type | Organization
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Legal Business Name | NATHAN G HALSTEAD DDS MS PC
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 324 W SUPERIOR ST SUITE 100
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City | DULUTH
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State | MN
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Zip | 55802-1701
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Country | US
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Telephone | 218-722-5233
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Fax | 218-722-5661
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Provider Business Mailing Address
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Address Line | 324 W SUPERIOR ST SUITE 100
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City | DULUTH
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State | MN
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Zip | 55802-1701
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Country | US
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Telephone | 218-722-5233
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Fax | 218-722-5661
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | NONA G OLSON
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Credential |
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Telephone | 218-722-5233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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