Organization
ST. ELIZABETHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERT HALL DDS (PROGRAM DIRECTOR)
(202) 299-5100
Entity
Organization
Contact information
Practice address
1100 ALABAMA AVE SE, WASHINGTON, DC 20032-4542
(202) 299-5100
Mailing address
915 SILVER SPRING AVE, SILVER SPRING, MD 20910-5052
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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