Provider Demographics
NPI:1083840862
Name:HALLOCK, ERIKA DANEAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:DANEAN
Last Name:HALLOCK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ERIKA
Other - Middle Name:DANEAN
Other - Last Name:BURD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1608 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-4481
Mailing Address - Country:US
Mailing Address - Phone:972-390-7200
Mailing Address - Fax:
Practice Address - Street 1:1608 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-4481
Practice Address - Country:US
Practice Address - Phone:972-390-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-07
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24681122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist