Individual
DR. JONATHAN PATRICK HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4116 E STATE BLVD, FORT WAYNE, IN 46815-6977
(260) 482-3759
(260) 482-3750
Mailing address
4116 E STATE BLVD, FORT WAYNE, IN 46815-6977
(260) 482-3759
(260) 482-3750
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012803A
IN
1223G0001X
General Practice Dentistry
DN 21405
FL
Other
Enumeration date
06/30/2015
Last updated
05/19/2025
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