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Organization
AUGUSTUS ALONZO HALL III DDS LLC
Active
Organization
AUGUSTUS ALONZO HALL III DDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AUGUSTUS A HALL III DDS (PRESIDENT)
(225) 928-9838
Entity
Organization
Contact information
Practice address
8220 GOODWOOD BLVD, #3B, BATON ROUGE, LA 70806-7741
(225) 928-9838
Mailing address
8220 GOODWOOD BLVD, #3B, BATON ROUGE, LA 70806-7741
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5478
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1854786
—
LA
Enumeration date
11/18/2014
Last updated
11/18/2014
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