Provider Demographics
NPI:1992466353
Name:DANIEL HALL DMD INC.
Entity type:Organization
Organization Name:DANIEL HALL DMD INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:858-215-2485
Mailing Address - Street 1:13350 CAMINO DEL SUR STE 3B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-4473
Mailing Address - Country:US
Mailing Address - Phone:858-215-2485
Mailing Address - Fax:858-905-3385
Practice Address - Street 1:13350 CAMINO DEL SUR STE 3B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-4473
Practice Address - Country:US
Practice Address - Phone:858-215-2485
Practice Address - Fax:858-905-3385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty