Provider Demographics
NPI:1417037276
Name:HALL, STEVEN MICHAEL (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:MICHAEL
Last Name:HALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 822
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:MD
Mailing Address - Zip Code:21811-0822
Mailing Address - Country:US
Mailing Address - Phone:410-641-2809
Mailing Address - Fax:
Practice Address - Street 1:9928 OLD OCEAN CITY BLVD
Practice Address - Street 2:SUITE 12
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1122
Practice Address - Country:US
Practice Address - Phone:410-629-0320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD75181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice