Provider Demographics
NPI:1679650998
Name:J HALL DENTAL ARTISTRY
Entity type:Organization
Organization Name:J HALL DENTAL ARTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:303-663-9600
Mailing Address - Street 1:1 OAKWOOD PARK
Mailing Address - Street 2:SUITE 206
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104
Mailing Address - Country:US
Mailing Address - Phone:303-663-9600
Mailing Address - Fax:303-663-9627
Practice Address - Street 1:1 OAKWOOD PARK
Practice Address - Street 2:SUITE 206
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104
Practice Address - Country:US
Practice Address - Phone:303-663-9600
Practice Address - Fax:303-663-9627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7718122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO7718OtherSTATE LICENSE