Provider Demographics
NPI:1487197935
Name:BRUCE A HALL DDS PC
Entity Type:Organization
Organization Name:BRUCE A HALL DDS PC
Other - Org Name:ARLINGTON DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-332-0431
Mailing Address - Street 1:931 ARLINGTON ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4055
Mailing Address - Country:US
Mailing Address - Phone:580-332-0431
Mailing Address - Fax:580-332-1362
Practice Address - Street 1:931 ARLINGTON ST
Practice Address - Street 2:SUITE 3
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4055
Practice Address - Country:US
Practice Address - Phone:580-332-0431
Practice Address - Fax:580-332-1362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty