Provider Demographics
NPI:1689735276
Name:HALL, THOMAS DURAND (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:DURAND
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 1:3612 COFFEE RD # A
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-5027
Mailing Address - Country:US
Mailing Address - Phone:661-391-9393
Mailing Address - Fax:661-589-9359
Practice Address - Street 1:3612 COFFEE RD # A
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-5027
Practice Address - Country:US
Practice Address - Phone:661-391-9393
Practice Address - Fax:661-589-9359
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice