NPI | 1174791891 |
---|---|
Professional Name | R. THANE HALES |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: UT 1319149923) |
Additional Taxonomies | 122300000X Dentist (Licence: UT 1319149923) |
Enumeration Date | 2008-02-15 |
Last Update Date | 2008-02-15 |