Provider Demographics
NPI:1790569549
Name:HALABO, SEAN HOWARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:HOWARD
Last Name:HALABO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:SEAN
Other - Middle Name:H
Other - Last Name:HALBO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:418 AVENIDA ABAJO
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-7771
Mailing Address - Country:US
Mailing Address - Phone:619-246-0007
Mailing Address - Fax:
Practice Address - Street 1:27701 SCOTT RD # D-107
Practice Address - Street 2:
Practice Address - City:MENIFEE
Practice Address - State:CA
Practice Address - Zip Code:92584-9417
Practice Address - Country:US
Practice Address - Phone:951-724-3195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist