Provider Demographics
NPI:1679923510
Name:HALL, LYNETTA (DENTAL HYGIENIST)
Entity Type:Individual
Prefix:
First Name:LYNETTA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 68TH STREET
Mailing Address - Street 2:US ARMY DENTAL ACTIVITY
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544-5054
Mailing Address - Country:US
Mailing Address - Phone:254-287-5929
Mailing Address - Fax:
Practice Address - Street 1:68TH STREET
Practice Address - Street 2:US ARMY DENTAL ACTIVITY BLDG 4431
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-287-5929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-21
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist