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NPI Code Detail

MEDICARE: HALLE N WATERS DMD INC

MEDICARE: HALLE N WATERS DMD INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1679383103
Entity Type Code : Organization
Provider Name (Legal Business Name) : HALLE N WATERS DMD INC
Provider Business Mailing Address
First Line : 34960 CENTER RIDGE RD
Second Line :
City : NORTH RIDGEVILLE
State : OH
Zip : 44039-3183
Country : US
Telephone Number : 440-327-6464
Fax Number :
Provider Business Practice Location Address
First Line : 34960 CENTER RIDGE RD
Second Line :
City : NORTH RIDGEVILLE
State : OH
Zip : 44039-3183
Country : US
Telephone Number : 440-327-6464
Fax Number :
Authorized Official
Title or Position : DENTIST OWNER
Name : DR. HALLE WATERS
Credential : DMD
Telephone Number : 440-327-6464
Provider Enumeration Date : 01/08/2025
Last Update Date : 01/08/2025

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