Provider Demographics
NPI:1992410252
Name:JD HALL DMD PA
Entity type:Organization
Organization Name:JD HALL DMD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-447-3708
Mailing Address - Street 1:4025 PEARIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BOSTIC
Mailing Address - State:NC
Mailing Address - Zip Code:28018-7741
Mailing Address - Country:US
Mailing Address - Phone:828-447-3708
Mailing Address - Fax:828-248-2276
Practice Address - Street 1:837 THUNDER RD
Practice Address - Street 2:
Practice Address - City:SPINDALE
Practice Address - State:NC
Practice Address - Zip Code:28160-1152
Practice Address - Country:US
Practice Address - Phone:828-287-7592
Practice Address - Fax:828-395-2228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty