Provider Demographics
NPI:1841381480
Name:HALLMAN, DAVID MICHAEL
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:HALLMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4787 OKEMOS RD
Mailing Address - Street 2:STE. # 1
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-1634
Mailing Address - Country:US
Mailing Address - Phone:517-349-4560
Mailing Address - Fax:517-349-9638
Practice Address - Street 1:4787 OKEMOS RD
Practice Address - Street 2:STE. # 1
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1634
Practice Address - Country:US
Practice Address - Phone:517-349-4560
Practice Address - Fax:517-349-9638
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI133341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice