Provider Demographics
NPI:1861603516
Name:HALL, CHRISTAL (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTAL
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2845 N HOUSTON LEVEE RD
Mailing Address - Street 2:101
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-0179
Mailing Address - Country:US
Mailing Address - Phone:901-266-0555
Mailing Address - Fax:901-266-3921
Practice Address - Street 1:2845 N HOUSTON LEVEE RD
Practice Address - Street 2:101
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0179
Practice Address - Country:US
Practice Address - Phone:901-266-0555
Practice Address - Fax:901-266-3921
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8642122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist