Provider Demographics
NPI:1871039461
Name:ERIC J. HALL, JR., DDS, P.A.
Entity Type:Organization
Organization Name:ERIC J. HALL, JR., DDS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-891-0300
Mailing Address - Street 1:2318 SAN JACINTO BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-7535
Mailing Address - Country:US
Mailing Address - Phone:940-891-0300
Mailing Address - Fax:
Practice Address - Street 1:2318 SAN JACINTO BLVD STE 104
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-7535
Practice Address - Country:US
Practice Address - Phone:940-891-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty