Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 11029187-9924 | UT |
NPI | 1417344557 |
---|---|
Provider Name | Dr. Vance Patrick Hall |
First Address | Layton, UT 84041-6928 |
Second Address | Layton, UT 84041-6928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2015 |
Last Update Date | 25/06/2019 |