MEDICARE: DR. MURRAY FREDERICK HALLETT DDS MAGD

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
1	1223G0001X	General Practice Dentistry	11200	OH

General Provider Information

NPI Number	:	1710063946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MURRAY FREDERICK HALLETT DDS MAGD

Provider Business Mailing Address
First Line	:	4352 SYLVANIA AVE
Second Line	:	SUITE E
City	:	TOLEDO
State	:	OH
Zip	:	43623
Country	:	US
Telephone Number	:	419-882-2024
Fax Number	:	419-882-6673

Provider Business Practice Location Address
First Line	:	4352 SYLVANIA AVE
Second Line	:	SUITE E
City	:	TOLEDO
State	:	OH
Zip	:	43623
Country	:	US
Telephone Number	:	419-882-2024
Fax Number	:	419-882-6673

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	07/08/2007

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