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1053358366
KENNETH BRADLEY HALL
WATKINSVILLE, GA
NPI
1053358366
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: GA DN012753)
Enumeration Date
2006-06-02
Last Update Date
2016-12-13
Business Address
Dr. KENNETH BRADLEY HALL DMD
1360 CADUCEUS WAY BLDG 900 STE 101
WATKINSVILLE, GA 30677-7300
Phone number: 706-543-3629
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Mailing Address
Dr. KENNETH BRADLEY HALL DMD
1360 CADUCEUS WAY BLDG 900 STE 101
WATKINSVILLE, GA 30677-7300
Phone number: 706-543-3629
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CLASSIC CITY ORTHODONTICS, LLC