Provider Demographics
NPI:1497595169
Name:HALL, DIARMID IAN (DMD)
Entity type:Individual
Prefix:DR
First Name:DIARMID
Middle Name:IAN
Last Name:HALL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9683 S ZAKRO LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-6064
Mailing Address - Country:US
Mailing Address - Phone:509-344-9024
Mailing Address - Fax:
Practice Address - Street 1:8159 S 4800 W
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84088-4703
Practice Address - Country:US
Practice Address - Phone:801-613-1816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13922810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist