Individual
DR. BRENDA JEAN HALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MD
Contact information
Practice address
1463 KLONDIKE RD SW, SUITE C, CONYERS, GA 30094-5127
(770) 483-9692
Mailing address
2208 ZERMATT CT SE, SMYRNA, GA 30080-6566
(404) 216-1981
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
5654
OK
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN013820
GA
Other
Enumeration date
02/14/2008
Last updated
10/21/2010
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