Provider Demographics
NPI:1588860506
Name:HALLIDAY, CHRISTINE RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:RENEE
Last Name:HALLIDAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 GLENN AVENUE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON CH
Mailing Address - State:OH
Mailing Address - Zip Code:43160
Mailing Address - Country:US
Mailing Address - Phone:740-335-7905
Mailing Address - Fax:740-333-7817
Practice Address - Street 1:211 GLENN AVENUE
Practice Address - Street 2:
Practice Address - City:WASHINGTON CH
Practice Address - State:OH
Practice Address - Zip Code:43160
Practice Address - Country:US
Practice Address - Phone:740-335-7905
Practice Address - Fax:740-333-7817
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH212061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice