Provider Demographics
NPI:1972311744
Name:HALL DENTAL GROUP PLLC
Entity type:Organization
Organization Name:HALL DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JACKSON
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-528-7977
Mailing Address - Street 1:390 S LOWE AVE STE G
Mailing Address - Street 2:
Mailing Address - City:COOKVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501
Mailing Address - Country:US
Mailing Address - Phone:931-528-7977
Mailing Address - Fax:931-528-7987
Practice Address - Street 1:390 S LOWE AVE STE G
Practice Address - Street 2:
Practice Address - City:COOKVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-528-7977
Practice Address - Fax:931-528-7987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-24
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty