Provider Demographics
NPI:1144603960
Name:DONALD HALE DENTAL GROUP, INC
Entity Type:Organization
Organization Name:DONALD HALE DENTAL GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HEMPFLENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:251-626-6869
Mailing Address - Street 1:1281 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4420
Mailing Address - Country:US
Mailing Address - Phone:251-626-6869
Mailing Address - Fax:
Practice Address - Street 1:301 E 1ST ST
Practice Address - Street 2:
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507-4029
Practice Address - Country:US
Practice Address - Phone:251-580-0979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty