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General NPI Number Information
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NPI Number | 1720116403
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Entity Type | Individual
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Provider Name | ALEXANDER HALL JR. DMD
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Gender | Male
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Dates
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Enumeration Date | 03/02/2007
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Last Update Date | 09/24/2018
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Provider Practice Location Address
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Address Line | 588 EAGLE ROCK AVENUE SUITE 1 2ND FLOOR
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City | WEST ORANGE
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State | NJ
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Zip | 07052
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Country | US
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Telephone | 973-674-1414
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Fax | 973-674-0473
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Provider Business Mailing Address
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Address Line | 110 BERGEN ST D718
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City | NEWARK
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State | NJ
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Zip | 07103-2495
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Country | US
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Telephone | 973-972-6005
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Fax | 973-972-4237
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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 | 14089
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 040717
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License Number State | NY
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