Provider Demographics
NPI:1083949002
Name:HILL-DAVIS DENTAL GROUP
Entity Type:Organization
Organization Name:HILL-DAVIS DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMIE
Authorized Official - Middle Name:G
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-793-0651
Mailing Address - Street 1:3234 64TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-5760
Mailing Address - Country:US
Mailing Address - Phone:806-793-0651
Mailing Address - Fax:806-793-1338
Practice Address - Street 1:3234 64TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79413-5760
Practice Address - Country:US
Practice Address - Phone:806-793-0651
Practice Address - Fax:806-793-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty