Provider Demographics
NPI:1205032315
Name:HALE, ALICE DRANNON (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:DRANNON
Last Name:HALE
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 1:10 TEA OLIVE CT
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29803-4715
Mailing Address - Country:US
Mailing Address - Phone:803-649-0516
Mailing Address - Fax:803-649-0549
Practice Address - Street 1:10 TEA OLIVE CT
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29803-4715
Practice Address - Country:US
Practice Address - Phone:803-649-0516
Practice Address - Fax:803-649-0549
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4338122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist