Provider Demographics
NPI:1891822656
Name:WILLIAM J HALE
Entity Type:Organization
Organization Name:WILLIAM J HALE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:HALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-328-0406
Mailing Address - Street 1:3314 CRILL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:PALATKA
Mailing Address - State:FL
Mailing Address - Zip Code:32177-4149
Mailing Address - Country:US
Mailing Address - Phone:386-312-0305
Mailing Address - Fax:904-339-9424
Practice Address - Street 1:3314 CRILL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:PALATKA
Practice Address - State:FL
Practice Address - Zip Code:32177-4149
Practice Address - Country:US
Practice Address - Phone:386-312-0305
Practice Address - Fax:904-339-9424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty