Provider Demographics
NPI:1235202896
Name:HILL, MELISSA GARRETT (DMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:GARRETT
Last Name:HILL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 JONESBORO RD
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-2050
Mailing Address - Country:US
Mailing Address - Phone:770-306-2266
Mailing Address - Fax:770-306-9111
Practice Address - Street 1:4550 JONESBORO RD
Practice Address - Street 2:SUITE A-1
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-2050
Practice Address - Country:US
Practice Address - Phone:770-306-2266
Practice Address - Fax:770-306-9111
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00678015CMedicaid