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General NPI Number Information
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NPI Number | 1952381154
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Entity Type | Individual
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Provider Name | JOHN CHRISTOPHER HALL DDS MS
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Gender | Male
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 4944 SKYVIEW CT
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-7173
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Country | US
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Telephone | 231-946-2910
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Fax | 231-948-9114
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Provider Business Mailing Address
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Address Line | 4944 SKYVIEW CT
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City | TRAVERSE CITY
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State | MI
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Zip | 49684-7173
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Country | US
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Telephone | 319-462-9102
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Fax | 231-946-9114
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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 | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2901016718
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License Number State | MI
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