Provider Demographics
NPI:1285957738
Name:HALL, ERIC NEAL (DMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:NEAL
Last Name:HALL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 RIVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-2211
Mailing Address - Country:US
Mailing Address - Phone:478-390-6503
Mailing Address - Fax:
Practice Address - Street 1:1023 RIVER RIDGE DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2211
Practice Address - Country:US
Practice Address - Phone:478-390-6503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0139051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice