Provider Demographics
NPI:1205157385
Name:HALLOCK, MICHAEL JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:HALLOCK
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 VIRGINIA PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5815
Mailing Address - Country:US
Mailing Address - Phone:972-547-1775
Mailing Address - Fax:
Practice Address - Street 1:7210 VIRGINIA PKWY STE 110
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5815
Practice Address - Country:US
Practice Address - Phone:972-547-1775
Practice Address - Fax:972-632-1111
Is Sole Proprietor?:No
Enumeration Date:2010-06-12
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice