Individual
DR. DANIEL HALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
520 N 12TH ST, RICHMOND, VA 23298-5064
(840) 828-9356
Mailing address
6504 WESSEX LN, RICHMOND, VA 23226-3024
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0442000362
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0442000362
TEMPORARY RESIDENT DENTAL LICENSE IN VIRGINIA
VA
Enumeration date
07/26/2019
Last updated
09/30/2019
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