Provider Demographics
NPI:1275653354
Name:HILLMAN, DARREL FRITZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:DARREL
Middle Name:FRITZ
Last Name:HILLMAN
Suffix:
Gender:M
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:PO BOX 360458
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00936-0458
Mailing Address - Country:US
Mailing Address - Phone:787-751-6324
Mailing Address - Fax:787-751-6324
Practice Address - Street 1:576 CALLE CESAR GONZALEZ
Practice Address - Street 2:DORAL BANK CENTER SUITE 407
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-3756
Practice Address - Country:US
Practice Address - Phone:787-751-6324
Practice Address - Fax:787-772-9436
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice