Organization
JAMES B. HALL, DDS, MS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES BENEDICT HALL DDS, MS (PRESIDENT)
(478) 743-0901
Entity
Organization
Contact information
Practice address
160 PIERCE AVENUE, MACON, GA 31204
(478) 743-0901
(478) 745-8615
Mailing address
160 PIERCE AVENUE, MACON, GA 31204
(478) 743-0901
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
7573
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00046395A
—
GA
01
—
100203
AVESIS DENTAL
GA
01
—
108232
DORAL DENTAL USA
GA
Enumeration date
04/24/2007
Last updated
07/28/2008
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