Provider Demographics
NPI:1033480215
Name:HILLTOP DENTAL GROUP
Entity Type:Organization
Organization Name:HILLTOP DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MARAT
Authorized Official - Middle Name:
Authorized Official - Last Name:FAINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-331-7699
Mailing Address - Street 1:5075 LEETSDALE DR
Mailing Address - Street 2:UNIT F
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8176
Mailing Address - Country:US
Mailing Address - Phone:303-377-4445
Mailing Address - Fax:303-377-4446
Practice Address - Street 1:5075 LEETSDALE DR
Practice Address - Street 2:UNIT F
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-8176
Practice Address - Country:US
Practice Address - Phone:303-377-4445
Practice Address - Fax:303-377-4446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN101341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty