Provider Demographics
NPI:1558185447
Name:MICHAEL J HALLOCK DDS PA
Entity type:Organization
Organization Name:MICHAEL J HALLOCK DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HALLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-547-1775
Mailing Address - Street 1:7210 VIRGINIA PKWY STE 110
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5815
Mailing Address - Country:US
Mailing Address - Phone:972-547-1775
Mailing Address - Fax:972-632-1111
Practice Address - Street 1:7210 VIRGINIA PKWY STE 110
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5815
Practice Address - Country:US
Practice Address - Phone:972-547-1775
Practice Address - Fax:972-632-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental