Timothy Michael Hall, DDS
Individual provider Active NPI General Practice Dentistry · Connell, WA
NPI 1508240235 · NPPES record last updated Sep 16, 2021
Key facts
- NPI
- 1508240235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE61069483 (WA)
- Practice address
- 1301 N Ephrata Ave
Connell, WA 99326-9601 - Phone
- (509) 543-5978
- NPI assigned
- Jul 13, 2015
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61069483 | WA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE61069483 | WA | Yes |
Addresses
Primary practice location
1301 N Ephrata Ave
Connell, WA 99326-9601
Mailing address
10504 S Clearview LN
Kennewick, WA 99338-2062
Phone (317) 903-0245
Other providers in Connell, WA
- Gary Byron Fletcher
- Jessica Lynn Forsyth
- Linda Gimmeson
- Gwyn Renee Gregg
- Dora G Gutierrez
- Tony A Harrington
- Chelsie Anne Henden
- Helen Elizabeth Jack
- Jaeniffer Ang Kaiser
- Shelbie Louise Karl
All providers in Connell, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.