Provider Demographics
NPI:1710984786
Name:HALAIS, RAYMOND (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:HALAIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:RAYMOND
Other - Middle Name:
Other - Last Name:HALAIS BORGES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 7706
Mailing Address - Street 2:
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00726-7706
Mailing Address - Country:US
Mailing Address - Phone:787-745-3636
Mailing Address - Fax:787-286-3636
Practice Address - Street 1:201 CALLE GAUTIER BENITEZ
Practice Address - Street 2:STE 200
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725-5527
Practice Address - Country:US
Practice Address - Phone:787-745-3636
Practice Address - Fax:787-286-3636
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR18931223E0200X
MA178491223E0200X
GADN0137971223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics