MEDICARE: DR. DENNIS E. HALFORD DDS MS

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	305R00000X	Preferred Provider Organization	12.659	TX

General Provider Information

NPI Number	:	1760501985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR. DENNIS E. HALFORD DDS MS

Provider Business Mailing Address
First Line	:	4503 SWEETWATER BLVD
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3010
Country	:	US
Telephone Number	:	281-980-8351
Fax Number	:	281-980-6151

Provider Business Practice Location Address
First Line	:	4503 SWEETWATER BLVD
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77479-3010
Country	:	US
Telephone Number	:	281-980-8351
Fax Number	:	281-980-6151

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. SUE MARTIN
Credential	:
Telephone Number	:	281-980-8351

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	12/15/2009

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