Provider Demographics
NPI:1730520107
Name:WATERS, HALLE N (DMD)
Entity type:Individual
Prefix:DR
First Name:HALLE
Middle Name:N
Last Name:WATERS
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 1:3865 ROCKY RIVER DRIVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44111
Mailing Address - Country:US
Mailing Address - Phone:216-941-4900
Mailing Address - Fax:216-941-1419
Practice Address - Street 1:3865 ROCKY RIVER DR
Practice Address - Street 2:SUITE 7
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-4114
Practice Address - Country:US
Practice Address - Phone:216-941-4900
Practice Address - Fax:216-941-1419
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-024031122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist