Provider Demographics
NPI:1114600533
Name:HALLMARK DENTAL PLLC
Entity Type:Organization
Organization Name:HALLMARK DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEMIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-326-9591
Mailing Address - Street 1:1585 MALLORY LN STE 101
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-3036
Mailing Address - Country:US
Mailing Address - Phone:615-377-6306
Mailing Address - Fax:
Practice Address - Street 1:1585 MALLORY LN STE 101
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3036
Practice Address - Country:US
Practice Address - Phone:615-377-6306
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental