Organization
HG HALL DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI BRENNAN (PRACTICE MANAGER)
(478) 268-9000
Entity
Organization
Contact information
Practice address
302 W MAIN ST, SWAINSBORO, GA 30401-3154
(478) 268-9000
(478) 268-9005
Mailing address
302 W MAIN ST, SWAINSBORO, GA 30401-3154
(478) 268-9000
(478) 268-9005
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10327
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1740340900
NPI TYPE 1
GA
Enumeration date
08/26/2015
Last updated
08/26/2015
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