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Individual

MR. LONNIE BRUCE HALL I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
329 60TH ST, WEST NEW YORK, NJ 07093-5497
(201) 868-0070
(201) 869-4030
Mailing address
329 60TH ST, WEST NEW YORK, NJ 07093-5497
(201) 868-0070
(201) 869-4030

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
22DIO13411800
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0845108
NJ
Enumeration date
03/22/2007
Last updated
07/09/2007
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