1710163571 NPI number — SCHIMPFHAUSER AND HALLER, PLLC

Table of content: (NPI 1710163571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710163571 NPI number — SCHIMPFHAUSER AND HALLER, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHIMPFHAUSER AND HALLER, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CURETON COSMETIC AND FAMILY DENTISTRY
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710163571
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1016 IRISH MOSS LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MATTHEWS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28104-6227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-843-3270
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8175 KENSINGTON DR. SUITE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAXHAW
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28173
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-843-3270
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/11/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HALLER
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
704-843-3270

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  8218 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)