Provider Demographics
NPI:1891109682
Name:HALL, EMILY (DMD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1425 S GREENFIELD RD
Mailing Address - Street 2:BLDG 2, STE 110
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-5529
Mailing Address - Country:US
Mailing Address - Phone:480-854-3434
Mailing Address - Fax:
Practice Address - Street 1:1425 S GREENFIELD RD
Practice Address - Street 2:BLDG 2, STE 110
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-5529
Practice Address - Country:US
Practice Address - Phone:480-854-3434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2015-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0089981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice