Provider Demographics
NPI:1295861367
Name:HALL, PAUL (PAUL HALL,DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:HALL
Suffix:
Gender:M
Credentials:PAUL HALL,DDS
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PAUL HALL, DDS
Mailing Address - Street 1:901 CAMPUS DR STE 204
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4930
Mailing Address - Country:US
Mailing Address - Phone:650-992-7874
Mailing Address - Fax:
Practice Address - Street 1:901 CAMPUS DR STE 204
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-4930
Practice Address - Country:US
Practice Address - Phone:650-992-7874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA307701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery