Provider Demographics
NPI:1982702171
Name:HALL, MARK K (DDS)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:K
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 1:5225 SW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2329
Mailing Address - Country:US
Mailing Address - Phone:785-273-1544
Mailing Address - Fax:785-273-3524
Practice Address - Street 1:5225 SW 7TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2329
Practice Address - Country:US
Practice Address - Phone:785-273-1544
Practice Address - Fax:785-273-3524
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS7056122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist