Provider Demographics
NPI:1093899460
Name:HILLSMAN, JOHN LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:LEE
Last Name:HILLSMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:997 OLD US 70
Mailing Address - Street 2:SUITE C
Mailing Address - City:BLACK MOUNTAIN
Mailing Address - State:NC
Mailing Address - Zip Code:28757
Mailing Address - Country:US
Mailing Address - Phone:828-669-4119
Mailing Address - Fax:828-669-1804
Practice Address - Street 1:997 OLD US 70
Practice Address - Street 2:SUITE C
Practice Address - City:BLACK MOUNTAIN
Practice Address - State:NC
Practice Address - Zip Code:28757
Practice Address - Country:US
Practice Address - Phone:828-669-7205
Practice Address - Fax:828-669-1804
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNC27831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice