Provider Demographics
NPI:1043279409
Name:HALASZ, MICHAEL H (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:H
Last Name:HALASZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9146 BEACON LIGHT CT
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-3638
Mailing Address - Country:US
Mailing Address - Phone:937-886-0811
Mailing Address - Fax:937-886-0811
Practice Address - Street 1:205 E STROOP RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-2825
Practice Address - Country:US
Practice Address - Phone:937-298-9028
Practice Address - Fax:937-298-9027
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0196081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice