Provider Demographics
NPI:1750499166
Name:DRS HALPIN PSC
Entity Type:Organization
Organization Name:DRS HALPIN PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JARED
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HALPIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-491-3411
Mailing Address - Street 1:5150 TAYLOR MILL ROAD
Mailing Address - Street 2:
Mailing Address - City:TAYLOR MILL
Mailing Address - State:KY
Mailing Address - Zip Code:41015
Mailing Address - Country:US
Mailing Address - Phone:859-491-3411
Mailing Address - Fax:859-491-3417
Practice Address - Street 1:5150 TAYLOR MILL ROAD
Practice Address - Street 2:
Practice Address - City:TAYLOR MILL
Practice Address - State:KY
Practice Address - Zip Code:41015
Practice Address - Country:US
Practice Address - Phone:859-491-3411
Practice Address - Fax:859-491-3417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-26
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4591122300000X
KY8203122300000X
KY5099122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty