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General NPI Number Information
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NPI Number | 1154584522
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Entity Type | Individual
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Provider Name | MICHAEL A HULL DMD
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Gender | Male
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Dates
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Enumeration Date | 07/07/2008
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Last Update Date | 01/09/2013
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Provider Practice Location Address
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Address Line | 105 HUDSON DR SUITE 9B
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City | ELIZABETHTON
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State | TN
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Zip | 37643-2801
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Country | US
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Telephone | 423-543-5263
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Fax |
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Provider Business Mailing Address
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Address Line | 179 JOHN COX RD
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City | GRAY
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State | TN
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Zip | 37615-4526
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 0401412203
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS0000009381
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License Number State | TN
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