Provider Demographics
NPI:1407297583
Name:ERIKA HALLOCK DDS PA
Entity Type:Organization
Organization Name:ERIKA HALLOCK DDS PA
Other - Org Name:HALLOCK FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-390-7200
Mailing Address - Street 1:1608 E MAIN ST
Mailing Address - Street 2:#200
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:972-390-7215
Practice Address - Street 1:1608 E MAIN ST
Practice Address - Street 2:#200
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:972-390-7215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-17
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX246811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty