Provider Demographics
NPI:1376573840
Name:HILL, SAMUEL LANE II (DDS)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:LANE
Last Name:HILL
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8327 ODOWLING
Mailing Address - Street 2:
Mailing Address - City:ONSTED
Mailing Address - State:MI
Mailing Address - Zip Code:49265-9489
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 EAST AVENUE
Practice Address - Street 2:
Practice Address - City:NAPOLEON
Practice Address - State:MI
Practice Address - Zip Code:49261
Practice Address - Country:US
Practice Address - Phone:517-536-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI97511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice