Provider Demographics
NPI:1548314255
Name:HALL, STEVEN WESTON (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WESTON
Last Name:HALL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2815 S RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89146-5166
Mailing Address - Country:US
Mailing Address - Phone:702-362-9974
Mailing Address - Fax:702-362-0107
Practice Address - Street 1:2815 S RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-5166
Practice Address - Country:US
Practice Address - Phone:702-362-9974
Practice Address - Fax:702-362-0107
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice