Provider Demographics
NPI:1760524565
Name:HALL, NATHAN ERIC (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ERIC
Last Name:HALL
Suffix:
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:613 EASTBURY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-7605
Mailing Address - Country:US
Mailing Address - Phone:319-338-7931
Mailing Address - Fax:319-338-7933
Practice Address - Street 1:613 EASTBURY DR STE 100
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-7605
Practice Address - Country:US
Practice Address - Phone:319-338-7931
Practice Address - Fax:319-338-7933
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083131223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics