Provider Demographics
NPI:1821263781
Name:HALE, DENISE DAWN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:DAWN
Last Name:HALE
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 1:9944 S ROBERTS RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1555
Mailing Address - Country:US
Mailing Address - Phone:708-599-7090
Mailing Address - Fax:
Practice Address - Street 1:9944 S ROBERTS RD
Practice Address - Street 2:SUITE 207
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1555
Practice Address - Country:US
Practice Address - Phone:708-599-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019021393122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1881747467OtherNPI FOR MY S-CORPORATION