Provider Demographics
NPI:1770528408
Name:HALL-REAGAN, PAULA MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:MARIE
Last Name:HALL-REAGAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:MARIE
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:6140 YORKRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-8397
Mailing Address - Country:US
Mailing Address - Phone:770-844-8290
Mailing Address - Fax:
Practice Address - Street 1:1290 ATHENS ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30507-7000
Practice Address - Country:US
Practice Address - Phone:770-531-5650
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0107881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice