Provider Demographics
NPI:1063634533
Name:HILL, FREDERICK JAY (DMD)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JAY
Last Name:HILL
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:250 W LANCASTER AVE
Mailing Address - Street 2:#230
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1743
Mailing Address - Country:US
Mailing Address - Phone:610-644-1222
Mailing Address - Fax:610-993-0186
Practice Address - Street 1:250 W LANCASTER AVE
Practice Address - Street 2:#230
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1743
Practice Address - Country:US
Practice Address - Phone:610-644-1222
Practice Address - Fax:610-993-0186
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS018644L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics