Provider Demographics
NPI:1558090761
Name:GROVE, HALLE THERESE (DMD)
Entity type:Individual
Prefix:
First Name:HALLE
Middle Name:THERESE
Last Name:GROVE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 PITT ST
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2102
Mailing Address - Country:US
Mailing Address - Phone:724-683-3049
Mailing Address - Fax:724-683-3050
Practice Address - Street 1:176 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:PA
Practice Address - Zip Code:15074-1723
Practice Address - Country:US
Practice Address - Phone:724-683-3049
Practice Address - Fax:724-683-3050
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS043598122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist