Provider Demographics
NPI:1780935619
Name:HALSTEAD DENTAL CLINIC- GREENSBURG
Entity type:Organization
Organization Name:HALSTEAD DENTAL CLINIC- GREENSBURG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-835-2070
Mailing Address - Street 1:212 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HALSTEAD
Mailing Address - State:KS
Mailing Address - Zip Code:67056-1913
Mailing Address - Country:US
Mailing Address - Phone:316-835-2070
Mailing Address - Fax:316-835-2008
Practice Address - Street 1:721 W KANSAS AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:KS
Practice Address - Zip Code:67054-1633
Practice Address - Country:US
Practice Address - Phone:316-835-2070
Practice Address - Fax:316-835-2008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DR. ROBERT L. SWEET D.D.S.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-10-02
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty