Provider Demographics
NPI:1710063946
Name:HALLETT, MURRAY FREDERICK (DDS MAGD)
Entity Type:Individual
Prefix:DR
First Name:MURRAY
Middle Name:FREDERICK
Last Name:HALLETT
Suffix:
Gender:M
Credentials:DDS MAGD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4352 SYLVANIA AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623
Mailing Address - Country:US
Mailing Address - Phone:419-882-2024
Mailing Address - Fax:419-882-6673
Practice Address - Street 1:4352 SYLVANIA AVE
Practice Address - Street 2:SUITE E
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623
Practice Address - Country:US
Practice Address - Phone:419-882-2024
Practice Address - Fax:419-882-6673
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH112001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice