Provider Demographics
NPI:1144425133
Name:GREGG T. HILLERY DMD LLC
Entity Type:Organization
Organization Name:GREGG T. HILLERY DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGG
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HILLERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-669-2688
Mailing Address - Street 1:2 HIGHVIEW CIR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-4724
Mailing Address - Country:US
Mailing Address - Phone:603-669-2688
Mailing Address - Fax:
Practice Address - Street 1:20 12 SOUTH STATE STREET
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-224-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH30711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty