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General NPI Number Information
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NPI Number | 1770750325
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Entity Type | Individual
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Provider Name | STAYNER HALLER DDS
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Gender | Male
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 05/13/2008
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Provider Practice Location Address
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Address Line | 1322 E MICHIGAN AVE SPARROW MEDICAL ARTS BUILING SUITE 302
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City | LANSING
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State | MI
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Zip | 48912-2176
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Country | US
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Telephone | 517-484-4515
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Fax |
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Provider Business Mailing Address
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Address Line | 1322 E MICHIGAN AVE SPARROW MEDICAL ARTS BUILDING SUITE 302
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City | LANSING
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State | MI
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Zip | 48912-2176
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Country | US
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Telephone | 517-484-4515
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Fax |
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 8397
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | E22
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License Number State | MI
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