Provider Demographics
NPI:1346696705
Name:HILLCREST DENTAL, P.C.
Entity Type:Organization
Organization Name:HILLCREST DENTAL, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:KUZHIPPALLIL
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-859-0363
Mailing Address - Street 1:225 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:08865-1529
Mailing Address - Country:US
Mailing Address - Phone:908-859-0363
Mailing Address - Fax:908-859-0651
Practice Address - Street 1:225 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:PHILLIPSBURG
Practice Address - State:NJ
Practice Address - Zip Code:08865-1529
Practice Address - Country:US
Practice Address - Phone:908-859-0363
Practice Address - Fax:908-859-0651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty