Provider Demographics
NPI:1114060464
Name:HALL, WILLIAM ALLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ALLEN
Last Name:HALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6658 ASHEBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-5375
Mailing Address - Country:US
Mailing Address - Phone:770-947-2385
Mailing Address - Fax:770-441-0299
Practice Address - Street 1:3271 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2384
Practice Address - Country:US
Practice Address - Phone:678-836-2111
Practice Address - Fax:770-441-0299
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0108941223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice