NPI 1003361130
Halle Park Family Dentistry, P.C.
Practice location
- Address
- 1108 Halle Park Cir, Collierville, TN 38017-7084
- Phone
- (901) 457-7753
- Mailing address
- 1090 Northchase Pkwy SE STE 150, Marietta, GA 30067-6405
Authorised official
- Name
- Ettienne van Zyl
- Title
- President
- Phone
- (901) 457-7753
Registered specialties (6)
General Practice Dentistry
Primary
Dentist
Endodontics
Pediatric Dentistry
Oral and Maxillofacial Surgery (Dentist)
Orthodontics and Dentofacial Orthopedics Dentistry
Registry record
- NPI
- 1003361130
- Entity type
- Organization
- NPI issued
- 18 Aug 2016
- Record last updated
- 18 Aug 2016
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.