Provider Demographics
NPI:1114038569
Name:HILL, DARYL KENT (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:DARYL
Middle Name:KENT
Last Name:HILL
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SHOREWOOD DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46385-7710
Mailing Address - Country:US
Mailing Address - Phone:219-465-0332
Mailing Address - Fax:
Practice Address - Street 1:8231 CALUMET AVE
Practice Address - Street 2:
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-1703
Practice Address - Country:US
Practice Address - Phone:219-836-0888
Practice Address - Fax:219-836-8855
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN120077811223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics