Provider Demographics
NPI:1356516561
Name:WILLIAM J HALL DDS PA
Entity type:Organization
Organization Name:WILLIAM J HALL DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-662-6247
Mailing Address - Street 1:1090 WEST PATRICK ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-3967
Mailing Address - Country:US
Mailing Address - Phone:301-662-6247
Mailing Address - Fax:301-662-4146
Practice Address - Street 1:1090 WEST PATRICK ST
Practice Address - Street 2:SUITE B
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-3967
Practice Address - Country:US
Practice Address - Phone:301-662-6247
Practice Address - Fax:301-662-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11438122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty