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Individual

DR. JOHN REAGAN HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
2216 17TH ST, GULFPORT, MS 39501-2901
(228) 863-1911
(228) 863-9211
Mailing address
2216 17TH ST, GULFPORT, MS 39501-2901
(228) 863-1911
(228) 863-9211

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2761-93
MS

Other

Enumeration date
11/15/2006
Last updated
07/08/2007
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