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General NPI Number Information
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NPI Number | 1194938563
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Entity Type | Individual
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Provider Name | CYNTHIA P HALL D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 09/05/2013
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Provider Practice Location Address
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Address Line | 160 SAILORS DR
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City | ELLIJAY
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State | GA
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Zip | 30540-3743
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Country | US
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Telephone | 706-276-2828
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Fax | 706-276-2826
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Provider Business Mailing Address
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Address Line | 152 CLEAR CREEK VALLEY TRL
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City | ELLIJAY
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State | GA
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Zip | 30536-7975
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Country | US
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Telephone | 706-276-4685
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 011546
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License Number State | GA
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