Provider Demographics
NPI:1649282872
Name:HALE, STEPHEN CRAIG (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CRAIG
Last Name:HALE
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 1:2515 PALMER HWY
Mailing Address - Street 2:SUITE B
Mailing Address - City:TEXAS CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77590-7077
Mailing Address - Country:US
Mailing Address - Phone:409-945-6551
Mailing Address - Fax:409-945-9901
Practice Address - Street 1:2515 PALMER HWY
Practice Address - Street 2:SUITE B
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-7077
Practice Address - Country:US
Practice Address - Phone:409-945-6551
Practice Address - Fax:409-945-9901
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13882122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist