NPI 1063872703

Halston Thayer

Practitioner Dentist Apo, AP

Practice location

Address: 18th Medical Group. Unit 5142, Apo, AP 96368
Phone: (682) 559-3392
Mailing address: Psc 80 Box 14611, Apo, AP 96367-0049

Registered specialties

Dentist Primary

Dental Providers Taxonomy 122300000X Licence 32422 (TX)

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Registry record

NPI: 1063872703
Entity type: Individual
Sex (as registered): Male
NPI issued: 23 Feb 2016
Record last updated: 23 Feb 2017

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.