Individual
DR. JESSE PARK HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
USA DENTAL ACTIVITY, B 2817 REILLY ROAD, FORT BRAGG, NC 28310-7302
(910) 643-2196
Mailing address
USA DENTAL ACTIVITY, B 2817 REILLY ROAD, FORT BRAGG, NC 28310-7302
(910) 643-2196
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6603-15
WI
Other
Enumeration date
08/27/2010
Last updated
08/26/2013
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