Provider Demographics
NPI:1376757799
Name:HALL, RENEE Y (RDH)
Entity Type:Individual
Prefix:MS
First Name:RENEE
Middle Name:Y
Last Name:HALL
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:877 S. BOULDER ROAD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027
Mailing Address - Country:US
Mailing Address - Phone:303-665-8228
Mailing Address - Fax:303-665-8994
Practice Address - Street 1:877 SOUTH BOULDER ROAD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027
Practice Address - Country:US
Practice Address - Phone:303-665-8228
Practice Address - Fax:303-665-8994
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2675124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist