Provider Demographics
NPI:1881990653
Name:O'HALLORAN, TERESITA ALCARAZ (DDS)
Entity type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:ALCARAZ
Last Name:O'HALLORAN
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 1:255 STRAFFORD AVE
Mailing Address - Street 2:
Mailing Address - City:STRAFFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2522
Mailing Address - Country:US
Mailing Address - Phone:610-687-2868
Mailing Address - Fax:
Practice Address - Street 1:255 STRAFFORD AVE
Practice Address - Street 2:
Practice Address - City:STRAFFORD
Practice Address - State:PA
Practice Address - Zip Code:19087-2522
Practice Address - Country:US
Practice Address - Phone:610-687-2868
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS016100L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice