Provider Demographics
NPI:1104828839
Name:HOSACK, BIESZKA, HALVERSON, PLLC
Entity Type:Organization
Organization Name:HOSACK, BIESZKA, HALVERSON, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOSACK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:269-685-6826
Mailing Address - Street 1:353 NAOMI ST
Mailing Address - Street 2:
Mailing Address - City:PLAINWELL
Mailing Address - State:MI
Mailing Address - Zip Code:49080-1257
Mailing Address - Country:US
Mailing Address - Phone:269-685-6826
Mailing Address - Fax:269-685-5481
Practice Address - Street 1:353 NAOMI ST
Practice Address - Street 2:
Practice Address - City:PLAINWELL
Practice Address - State:MI
Practice Address - Zip Code:49080-1257
Practice Address - Country:US
Practice Address - Phone:269-685-6826
Practice Address - Fax:269-685-5481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI82421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty