Individual
DR. KIMRA L HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
410 MACON AVE, CANON CITY, CO 81212-3225
(719) 276-0117
(719) 276-0653
Mailing address
410 MACON AVE, CANON CITY, CO 81212-3225
(719) 276-0117
(719) 276-0653
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8336
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
88834062
—
CO
Enumeration date
10/17/2006
Last updated
05/24/2010
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