Provider Demographics
NPI:1184740276
Name:HALL, FOSTER VALE (DDS)
Entity type:Individual
Prefix:MR
First Name:FOSTER
Middle Name:VALE
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 1:5901 N. MAYFAIR #201
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207
Mailing Address - Country:US
Mailing Address - Phone:509-489-3791
Mailing Address - Fax:509-483-2272
Practice Address - Street 1:5901 N MAYFAIR ST
Practice Address - Street 2:#201
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-5096
Practice Address - Country:US
Practice Address - Phone:509-489-3791
Practice Address - Fax:509-483-2272
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5833122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5833OtherWA STATE LICENSE#
WABH0445418OtherDEA #