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General NPI Number Information
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NPI Number | 1851401590
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Entity Type | Organization
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Legal Business Name | HENRY A VAN HALA DDS INC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1515 PORTAGE ST NW
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City | NORTH CANTON
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State | OH
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Zip | 44720
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Country | US
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Telephone | 330-494-0646
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Fax | 330-494-9181
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Provider Business Mailing Address
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Address Line | 1515 PORTAGE ST NW
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City | NORTH CANTON
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State | OH
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Zip | 44720
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Country | US
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Telephone | 330-494-0646
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Fax | 330-494-9181
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. HOLLACE G VAN HALA
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Credential |
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Telephone | 330-685-3737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14482
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License Number State | OH
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