Provider Demographics
NPI:1386720753
Name:HALE, ANITA (DMD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:
Last Name:HALE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4807 KY ROUTE 321
Mailing Address - Street 2:
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-9113
Mailing Address - Country:US
Mailing Address - Phone:606-886-8400
Mailing Address - Fax:606-886-8471
Practice Address - Street 1:4807 KY ROUTE 321
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9113
Practice Address - Country:US
Practice Address - Phone:606-886-8400
Practice Address - Fax:606-886-8471
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2008-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY53631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice