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General NPI Number Information
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NPI Number | 1740412550
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Entity Type | Organization
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Legal Business Name | S. ZAK HALLOCK, DMD, INC
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Dates
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Enumeration Date | 08/12/2009
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 3716 WILMINGTON PIKE
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City | DAYTON
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State | OH
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Zip | 45429-4845
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Country | US
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Telephone | 937-296-9672
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Fax | 937-296-9678
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Provider Business Mailing Address
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Address Line | 3716 WILMINGTON PIKE
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City | DAYTON
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State | OH
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Zip | 45429-4845
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Country | US
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Telephone | 937-867-7664
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Fax | 937-296-9678
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Authorized Official
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Title or Position | OWNER
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Name | S. ZAK HALLOCK
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Credential | D.M.D.
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Telephone | 937-296-9672
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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 | 30.022787
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License Number State | OH
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