Provider Demographics
NPI:1750505434
Name:HALL, JASON PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:PATRICK
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 1:1 OAKWOOD PARK PLZ
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1882
Mailing Address - Country:US
Mailing Address - Phone:303-663-9600
Mailing Address - Fax:
Practice Address - Street 1:1 OAKWOOD PARK PLZ
Practice Address - Street 2:SUITE 206
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1882
Practice Address - Country:US
Practice Address - Phone:303-663-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist